gms | German Medical Science

66th Annual Meeting of the German Society of Neurosurgery (DGNC)
Friendship Meeting with the Italian Society of Neurosurgery (SINch)

German Society of Neurosurgery (DGNC)

7 - 10 June 2015, Karlsruhe

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Reduction of shunt-dependent hydrocephalus following aneurysmal subarachnoid hemorrhage by Lamina Terminalis fenestration: a mono-institutional experience

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  • Lorenzo Volpin - U.O. Neurochirurgia, Ospedale Civile San Bortolo, Vicenza, Italy
  • Alessandro Segna - U.O. Neurochirurgia, Ospedale Civile San Bortolo, Vicenza, Italy
  • Mariano Agostino Zanusso - U.O. Neurochirurgia, Ospedale Civile San Bortolo, Vicenza, Italy
  • Giampaolo Zambon - U.O. Neurochirurgia, Ospedale Civile San Bortolo, Vicenza, Italy
  • F. Volpin - U.O. Neurochirurgia, Ospedale Civile San Bortolo, Vicenza, Italy
  • G. Beggio - U.O. Neurochirurgia, Ospedale Civile San Bortolo, Vicenza, Italy
  • L. Alvaro - U.O. Neurochirurgia, Ospedale Civile San Bortolo, Vicenza, Italy

Deutsche Gesellschaft für Neurochirurgie. 66. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Karlsruhe, 07.-10.06.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. DocMI.12.03

doi: 10.3205/15dgnc326, urn:nbn:de:0183-15dgnc3264

Published: June 2, 2015

© 2015 Volpin et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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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.