Lumbar drainage as treatment of refractory intracranial hypertension in bacterial meningitis

2008 ◽  
Vol 34 (6) ◽  
pp. 1166-1167 ◽  
Author(s):  
Etienne Javouhey ◽  
Nathalie Richard ◽  
Didier Stamm ◽  
Daniel Floret
Keyword(s):  
Bacterial Meningitis ◽  
Intracranial Hypertension ◽  
Lumbar Drainage

A review of external lumbar drainage for the management of intracranial hypertension in traumatic brain injury

2021 ◽  
Author(s):  
Elizabeth E Ginalis ◽  
Laura L Fernández ◽  
Juan P Ávila ◽  
Sarita Aristizabal ◽  
Andres M Rubiano
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Intracranial Hypertension ◽  
Lumbar Drainage ◽  
External Lumbar Drainage

External Lumbar Drainage for Refractory Intracranial Hypertension in Traumatic Brain Injury: A Systematic Review

2021 ◽  
Author(s):  
Andrew Robert Stevens ◽  
Wai Cheong Soon ◽  
Yasir Arafat Chowdhury ◽  
Emma Toman ◽  
Antonio Belli ◽  
...  
Keyword(s):  
Systematic Review ◽  
Intracranial Hypertension ◽  
Medical Therapy ◽  
Data Extraction ◽  
Lumbar Drainage ◽  
Safety Reporting ◽  
Sustained Effect ◽  
Cerebral Herniation ◽  
Adverse Patient Outcome ◽  
External Lumbar Drainage

Abstract BackgroundExternal lumbar drainage remains a controversial therapy for medically refractory intracranial hypertension in patients with acute TBI. This systematic review sought to compile the available evidence for the efficacy and safety of the use of lumbar drains for ICP control. MethodsA systematic review of the literature was performed with the search and data extraction performed by two reviewers independently in duplicate.ResultsNine independent studies were identified enrolling 230 patients, 159 with TBI. Efficacy for ICP control was observed across all studies, with immediate and sustained effect, reducing medical therapy requirements. Lumbar drainage with medical therapy appears effective when used alone and as an adjunct to ventricular drainage. Safety reporting varied in quality. Cerebral herniation (with unclear relationship to lumbar drainage) was observed in 14/230 patients resulting in one incident of morbidity without adverse patient outcome. ConclusionsThe available data is generally poor in quality and volume, but supportive of efficacy of lumbar drainage for ICP control. Few reports of adverse outcome are suggestive of, but are insufficient to confirm, safety of use in the appropriate patient and clinical setting. Further large prospective observational studies are required to generate sufficient support of an acceptable safety profile.

External lumbar drainage in progressive pediatric idiopathic intracranial hypertension

2021 ◽  
pp. 1-7
Author(s):  
Gad Dotan ◽  
Natalie Hadar Cohen ◽  
Hanya M. Qureshi ◽  
Mika Shapira Rootman ◽  
Yoram Nevo ◽  
...  
Keyword(s):  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Vision Loss ◽  
Symptom Relief ◽  
Visual Outcome ◽  
Fiber Layer ◽  
Lumbar Drainage ◽  
Lumbar Drain ◽  
Rnfl Thickness ◽  
External Lumbar Drainage

OBJECTIVE Pediatric idiopathic intracranial hypertension (IIH) is characterized by increased intracranial pressure despite normal cerebrospinal fluid and neuroimaging findings. Initial management is typically medical; however, nearly 10% of children will eventually require surgery for persistent headache and/or vision loss. External lumbar drainage, which is a considerably safer treatment option, has not been adequately analyzed in children with medically refractory IIH. METHODS The authors conducted a single-institution retrospective analysis of children with medically refractory IIH who had undergone external lumbar drain (ELD) placement because of worsening papilledema, reflected as increased retinal nerve fiber layer (RNFL) thickness on optical coherence tomography (OCT) testing. The main outcome measures were effects of external lumbar drainage on papilledema resolution, symptoms, and vision. RESULTS The authors analyzed the medical records of 13 children with IIH (11 girls, mean age 15.0 ± 2.3 years) whose mean CSF opening pressure was 45.5 ± 6.8 cm H2O. In all children, the average global RNFL thickness in both eyes significantly increased at ELD placement (right eye 371.8 ± 150.2 μm, left eye 400.3 ± 96.9 μm) compared with presentation thickness (right eye 301.6 ± 110.40 μm, left eye 350.2 ± 107.7 μm) despite acetazolamide medical therapy (20–30 mg/kg/day), leading to ELD placement after 9.5 ± 6.9 days (range 3–29 days). After ELD insertion, there was headache resolution, gradual and continuous improvement in optic disc thickness, and preservation of good vision. CONCLUSIONS ELD placement in children with medically refractory IIH who demonstrated worsening papilledema with increased RNFL thickening on OCT testing typically results in symptom relief and disc edema resolution with good visual outcome, often preventing the need for additional definitive surgeries that carry greater failure and morbidity risks.

Refractory posttraumatic intracranial hypertension: treatment with an external lumbar drainage

2005 ◽  
Vol 22 (Supplement 36) ◽  
pp. 9
Author(s):  
J. Homar ◽  
J. M. Abadal ◽  
J. A. Llompart ◽  
J. Perez ◽  
J. Ibáñez
Keyword(s):  
Intracranial Hypertension ◽  
Hypertension Treatment ◽  
Lumbar Drainage ◽  
External Lumbar Drainage

Lumbar Drainage for the Treatment of Severe Bacterial Meningitis

2013 ◽  
Vol 19 (2) ◽  
pp. 199-205 ◽  
Author(s):  
Yasser B. Abulhasan ◽  
Hosam Al-Jehani ◽  
Marie-Anne Valiquette ◽  
Anne McManus ◽  
Mylène Dolan-Cake ◽  
...  
Keyword(s):  
Bacterial Meningitis ◽  
Lumbar Drainage

scholarly journals Treatment of intracranial hypertension and aspects on lumbar dural puncture in severe bacterial meningitis

2002 ◽  
Vol 46 (3) ◽  
pp. 264-270 ◽  
Author(s):  
P-O. Grände ◽  
E. B. Myhre ◽  
C-H. Nordström ◽  
S. Schliamser
Keyword(s):  
Bacterial Meningitis ◽  
Intracranial Hypertension ◽  
Dural Puncture

scholarly journals External hydrocephalus in adults: an insidious cause of delayed intracranial hypertension. Report of 33 relevant cases treated with success by CSF lumbar drainage

2015 ◽  
Vol 12 (Suppl 1) ◽  
pp. P31
Author(s):  
Romain Manet ◽  
Romain Guerin ◽  
Orianne Martinez ◽  
Gilles Francony ◽  
Jean-Paul Roustan ◽  
...  
Keyword(s):  
Intracranial Hypertension ◽  
Lumbar Drainage ◽  
External Hydrocephalus

scholarly journals Neuro-Intensive Treatment Targeting Intracranial Hypertension Improves Outcome in Severe Bacterial Meningitis: An Intervention-Control Study

PLoS ONE ◽  
2014 ◽  
Vol 9 (3) ◽  
pp. e91976 ◽  
Author(s):  
Martin Glimåker ◽  
Bibi Johansson ◽  
Halla Halldorsdottir ◽  
Michael Wanecek ◽  
Adrian Elmi-Terander ◽  
...  
Keyword(s):  
Bacterial Meningitis ◽  
Intracranial Hypertension ◽  
Intensive Treatment ◽  
Control Study ◽  
Treatment Targeting

Meningitis in the Setting of Frontoethmoidal and Temporal Meningoencephaloceles

2020 ◽  
pp. 194187442095883
Author(s):  
Arooshi Kumar ◽  
Jugal Shah ◽  
Kara Melmed ◽  
Donato Pacione ◽  
Seth Lieberman ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Bacterial Meningitis ◽  
Intracranial Hypertension ◽  
Skull Base ◽  
Imaging Findings ◽  
Skull Base Defects

This is a patient with multiple meningoencephaloceles which resulted in bacterial meningitis and subsequent status epilepticus. We identify impressive imaging findings demonstrating herniation of the meninges from nasal and bitemporal skull base defects possibly as a result of intracranial hypertension.

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