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Published on: October 14, 2022
Transfrontal External Ventricular Drainage Combined with OMMAYA Sac Implantation under Laser Navigation were
Zhengbo Yuan1, Zhijie Cao2, Zefu Li1
1Department of Neurosurgery, Binzhou Medical University Hospital.
Insights
This study introduces a novel transfrontal external ventricular drainage (EVD) technique for hydrocephalus due to intracerebral hemorrhage (ICH). Laser-navigated EVD effectively normalized intracranial pressure and improved patient outcomes, suggesting its potential as a valuable surgical option.
Area of Science:
- Neurosurgery
- Neurology
- Medical Technology
Background:
- Hydrocephalus secondary to intracerebral hemorrhage (ICH) presents significant challenges in patient management.
- Current treatment strategies for ICH-induced hydrocephalus often rely on surgeon experience, lacking standardized protocols.
Purpose of the Study:
- To evaluate the clinical efficacy of a newly developed transfrontal external ventricular drainage (EVD) system for managing ICH-induced hydrocephalus.
- To present a novel surgical approach that may offer an alternative to existing methods.
Main Methods:
- An open retrospective study involving 10 patients with spontaneous ICH.
- Patients underwent transfrontal lateral ventricle puncture and drainage utilizing laser navigation.
- Clinical data, radiological findings, and prognostic scores were analyzed.
Main Results:
- Emergency surgery was performed on 10 patients (average age 58.10±9.97 years).
- Intracranial pressure normalized within 11.25±3.81 days.
- Significant improvements were observed in Glasgow Coma Scale (GCS), National Institutes of Health Stroke Scale (NIHSS), and Activities of Daily Living (ADL) scores post-procedure and at follow-up.
Conclusions:
- Transfrontal EVD combined with OMMAYA sac implantation under laser navigation is a promising surgical intervention for ICH-related hydrocephalus.
- This technique warrants further investigation and may offer a valuable addition to the neurosurgical armamentarium.
Background:
Hydrocephalus caused by spontaneous intracerebral hemorrhage (ICH) is an independent risk factor with adverse effects on the progression of the disease. Until now, the choice of intraventricular catheter placement and intraventricular fibrinolysis (IVF) has been mainly based on the personal experience of the neurosurgeon.
Objective:
We will introduce the clinical effect of the new external ventricular drainage (EVD), an independent innovation of our medical center, on ICH patients, hoping to inspire more neurosurgeons to apply our method.
Methods:
In this open retrospective study, We analyzed the clinical data, radiological manifestations, and prognostic scores of 10 patients with the spontaneous intracerebral hemorrhage who received transfrontal lateral ventricle puncture and drainage under laser navigation in our hospital.
Results:
A total of 10 patients with an average age of 58.10±9.97 years were enrolled for emergency surgery. All operations were completed according to the consensus specifications. It took 11.25±3.81 days for the intracranial pressure to return to normal. On admission, patients had a median GCS of 10. The median preoperative GCS was 8. The median GCS at discharge score was 15. At discharge, the median NIHSS score was 4. After 6 months of follow-up, patients had a median NIHSS score of 4. At discharge, the median ADL score of patients was 85. After 6 months of follow-up, the median ADL score of the patients was 95.
Conclusion:
In treating patients with ICH, the emergency treatment of transfrontal external ventricular drainage combined with OMMAYA sac implantation under laser navigation is a surgical method worthy of further study.
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