Artikel
Reduction of shunt-dependent hydrocephalus following aneurysmal subarachnoid hemorrhage by Lamina Terminalis fenestration: a mono-institutional experience
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Veröffentlicht: | 2. Juni 2015 |
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Objective: Chronic hydrocephalus is a common complication following aneurismal subarachnoid hemorrhage affecting more than 20% of patients. According to Yasargil, Lamina Terminalis fenestration and meticulous cisternal lavage are able to reduce the percentage of shunt placement by promoting CSF dynamics.
Method: We retrospectively analyzed the patients operated on for microsurgical aneurismal clipping after SAH in our unit since 2006. All the patients (188) presented anterior circulation aneurysms and, during the surgical procedure, underwent third ventriculostomy by Lamina Terminalis fenestration (LTF) and meticulous cisternal lavage.
Results: 30 patient of 188 (15,9%) who underwent microsurgical clipping and LTF after SAH developed a shunt-dependent hydrocephalus needing a ventriculo-peritoneal shunt.
Conclusions: Lamina Terminalis fenestration is a safe and useful procedure that could reduce shunt dependency in patient affected by aneurismal SAH. Our results show a reduction of post SAH-chronic hydrocephalus improving neurological outcome. Since there is no consensus in literature on the efficacy of this procedure, further investigations and a multicenter trial are needed to confirm this positive trend.