MRimaging findings after ventricular puncture in patients with SAH

Using magnetic resonance (MR) imaging, we studied brain injury from ventricular puncture performed during craniotomy in the acute stage of subarachnoid hemorrhage (SAH). 80 patients underwent craniotomy for aneurysm obliteration within 48 hr after SAH, ventricular puncture for drainage of cerebrospi...

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Bibliographic Details
Published in:Acta neurochirurgica 2001-11, Vol.143 (11), p.1133-1140
Main Authors: Tominaga, J, Shimoda, M, Oda, S, Kumasaka, A, Yamazaki, K, Tsugane, R
Format: Article
Language:English
Subjects:
Acute Disease
Aged
Aneurysms
Brain damage
Brain Injuries - cerebrospinal fluid
Brain Injuries - pathology
Cerebral Ventricles - surgery
Craniotomy - methods
Drainage
Female
Hemorrhage
Humans
Injuries
Intracranial Aneurysm - complications
Intracranial Aneurysm - surgery
Logistic Models
Magnetic Resonance Imaging
Male
Medical diagnosis
Middle Aged
Punctures - adverse effects
Subarachnoid Hemorrhage - etiology
Tomography, X-Ray Computed
Treatment Outcome
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Summary:Using magnetic resonance (MR) imaging, we studied brain injury from ventricular puncture performed during craniotomy in the acute stage of subarachnoid hemorrhage (SAH). 80 patients underwent craniotomy for aneurysm obliteration within 48 hr after SAH, ventricular puncture for drainage of cerebrospinal fluid (CSF) was performed to reduce intracranial pressure. MR imaging was performed within 3 days following surgery to measure the size of the lesion, and was repeated on postoperative days 14 and 30. Of the 80 patients with ventricular puncture preceding craniotomy, 65 (81%) showed MR evidence of brain injury from the puncture. Overall, 149 lesions were detected. According to coronal images, cortical injuries (54 cases), penetrating injury to tracts along the ventricular tube (55 cases), caudate injury (25 cases), and corpus callosum injury (15 cases). Brain injuries from ventricular puncture did not correlate significantly to patient outcome. While ventricular puncture and drainage of CSF can readily be performed to decrease brain volume at the time of craniotomy in acute-stage SAH, neurosurgeons should be aware of a surprisingly high incidence of brain injury complicating puncture.
ISSN:0001-6268
0942-0940
DOI:10.1007/s007010100004