Controlled lumbar drainage in medically refractory increased intracranial pressure. A safe and effective treatment.

摘要: BACKGROUND A prospective study of lumbar CSF drainage in the setting raised intra-cranial pressure refractory to medical management and ventriculostomy placement is presented. There have been no controlled trials its use reported literature, best our knowledge. METHOD An IRB approved was conducted. 8 patients with increased intracranial secondary traumatic brain injury or aneurysm rupture were initially managed sedation, placement, mild hyperventilation (pCO2 = 30-35), hyperosmolar therapy (Na 150-155). drain placed if ICP continued be above 20 mmHg despite optimization therapy. FINDINGS After reduced from a mean 27 +/- 7.8 9 6.3, an average decrease 18 mm H2O (p < 0.05). Requirements for hypertonic saline and/or mannitol boluses sedation control also decreased. complications noted. CONCLUSIONS We shown that safe, efficacious minimally invasive method treatment elevated management. Ventriculostomies are always before utilizing drains minimize risk cerebral herniation. would advocate making standard part protocols.