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Cerebro spinal fluid withdrawal for the treatment of intra cranial hypertension in acute head injuries



Cerebro spinal fluid withdrawal for the treatment of intra cranial hypertension in acute head injuries



Acta Neurochirurgica 56(3-4): 191-200



Long-term ICP [intracranial pressure] recording was carried out in 151 acute head injury patients: 131 comatose patients admitted to ICU, and 20 non-comatose patients harboring intracerebral mass lesions (lacerations or hematomas) in whom a decision to operate was doubtful. CSF withdrawal was used in 39 cases: by intermittent subtraction in 23 patients, and by continuous ventricular drainage (VD) in the remainder. In the acute stage, within 72 h of injury, CSF subtraction proved of little use in influencing ICP or clinical time course. Conversely, at a latter stage, CSF withdrawal either by repeated intermittent subtraction or by continuous VD could very often control raised ICP. Some patients had to undergo permanent shunting eventually. Elevated ICP was also safely controlled in 4 out of 8 patients with intracerebral mass lesions and stationary symptoms. Such patients recovered quickly, and operation was avoided.

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Accession: 004902075

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