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68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

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Increased rate of ventriculostomy-related hemorrhage in patients following coiling of acutely ruptured aneurysms compared to clipping

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  • Christian Scheller - Universitätsklinikum Halle-Wittenberg, Neurochirurgische Klinik, Halle (Saale), Deutschland
  • Silvio Brandt - Universitätsklinikum Halle-Wittenberg, Neuroradiologie, Halle (Saale), Deutschland
  • Christian Strauss - Universitätsklinikum Halle/Saale, Klinik und Poliklinik für Neurochirurgie, Halle/Saale, Deutschland
  • Sebastian Simmermacher - Universitätsklinikum Halle-Wittenberg, Neurochirurgische Klinik, Halle (Saale), Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocDI.11.01

doi: 10.3205/17dgnc235, urn:nbn:de:0183-17dgnc2353

Published: June 9, 2017

© 2017 Scheller 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: Acutely ruptured aneurysms can be treated by coiling or clipping. After coiling the risk of thrombotic complications is reduced by the use of anticoagulative agents, which is not necessary after clipping. The aim of the study is to investigate the rate of ventriculostomy-related hemorrhage after coiling and clipping.

Methods: Between 2009 and 2016 101 patients with aneurysmal subarachnoid hemorrhage were treated with ventriculostomy and clipping (n=55) or coiling (n=46). Their CT scans were investigated retrospectively for ventriculostomy-related hemorrhage. Furthermore the rates of revision surgeries and bacterial ventriculitis were documented.

Results: Ventriculostomy-related hemorrhage was obserevd in 20 of 46 patients after coiling compared to 7 of 55 patients after clipping (ChiSquare test, p<0.001). Revision surgery was indicated in 75% and in 50% of these patients revision surgery was required more than once. In nearly 50% of the patients with ventriculostomy-related hemorrhage an additional bacterial ventriculitis was observed.

Conclusion: Ventriculostomy-related hemorrhage is an underestimated complication following coiling of acutely ruptured aneurysms. It is possible that the clinical course of patients with subarachnoidal hemorrhage is negatively influenced by dysfunction of the ventriculostomy, revision surgeries and bacterial infection.