Journal of Korean Neurosurgical Society

  • 제46권3호
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  • Pages.215-220
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  • 2009
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Brain Injuries during Intraoperative Ventriculostomy in the Aneurysmal Subarachnoid Hemorrhage Patients

  • Moon, Hyung-Ho (Department of Neurosurgery, Eulji University, Nowon Eulji Hospital) ;
  • Kim, Jae-Hoon (Department of Neurosurgery, Eulji University, Nowon Eulji Hospital) ;
  • Kang, Hee-In (Department of Neurosurgery, Eulji University, Nowon Eulji Hospital) ;
  • Moon, Byung-Gwan (Department of Neurosurgery, Eulji University, Nowon Eulji Hospital) ;
  • Lee, Seung-Jin (Department of Neurosurgery, Eulji University, Nowon Eulji Hospital) ;
  • Kim, Joo-Seung (Department of Neurosurgery, Eulji University, Nowon Eulji Hospital)
  • 발행 : 2009.09.28
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초록

Objective : Intraoperative ventriculostomy is widely adopted to make the slack brain. However, there are few reports about hemorrhagic or parenchymal injuries after ventriculostomy. We tried to analyze and investigate the incidence of these complications in a consecutive series of patients with aneurysmal subarachnoid hemorrhage (SAH). Methods : From September 2006 to June 2007, 43 patients underwent surgical clipping for aneurysmal SAH at our hospital. Among 43 patients, we investigated hemorrhagic or parenchymal injuries after intraoperative ventriculostomy using postoperative computed tomographic scan in 26 patients. After standard pterional craniotomy, ventriculostomy catheter was inserted perpendicular to the cortical surface along the bisectional imaginary line from Paine's point. Results : Hemorrhagic injuries were detected in 12 of 26 patients (46.2%). Mean systolic blood pressure during anesthesia was with in statistically significant parameter related to hemorrhage (p=0.006). On the other hand, parenchymal injuries were detected in 11 of 26 patients (42.3%). Female and the amount of infused mannitol during anesthesia showed statistically significant parameters related to parenchymal injury (p=0.005, 0.04, respectively). However, there were no ventriculostomy-related severe complications. Conclusion : In our series, hemorrhagic or parenchymal injuries after intraoperative ventriculostomy occurred more commonly than previously reported series in aneurysmal SAH patients. Although the clinical outcomes of complications are generally favorable, neurosurgeon must keep in mind the frequent occurrence of brain injury after intraoperative ventriculostomy in the acute stage of aneurysmal SAH.

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참고문헌

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피인용 문헌

  1. Accuracy and Safety of Bedside External Ventricular Drain Placement at Two Different Cranial Sites : Kocher's Point versus Forehead vol.50, pp.4, 2011, https://doi.org/10.3340/jkns.2011.50.4.317
  2. Development of a 3D-printed external ventricular drain placement simulator: technical note vol.123, pp.4, 2009, https://doi.org/10.3171/2014.12.jns141867