Dijksterhuis, W.B. (2020) The influence of cerebrospinal fluid markers on shunt function in post aneurysmal subarachnoid haemorrhage patients: a retrospective single centre cohort study. thesis, Medicine.
Full text available on request.Abstract
Background Chronic hydrocephalus is a common complication after aneurysmal subarachnoid haemorrhage (aSAH). Individual cerebrospinal fluid (CSF) blood cell and protein counts are often used for timing of permanent shunt surgery to reduce shunt failure risk. Methods A single centre 10-year retrospective study of adult patients (≥ 18 years), treated with ventriculoperitoneal shunt (VPS) insertion for chronic hydrocephalus secondary to aSAH, was conducted. The primary study parameters of interest were the erythrocyte, leukocyte, total protein and glucose contents of the pre-operative CSF and subsequent shunt failure. Shunts were implanted on the condition that the CSF was translucent (allowing xanthochromia). Shunt failures up to one year post-operatively were considered. Results A total of 53 patients were included. All patients presented with acute hydrocephalus following aSAH. Shunt failure occurred in 10 patients (18.9%), secondary to infection in 5 (9.4%) and due to obstruction in 2 (3.8%). CSF erythrocytes, leukocytes, protein and glucose were not correlated with overall shunt failure or obstruction. Integra OSV II valves were significantly associated with shunt obstruction (risk difference +0.20; 95% CI 0.011 – 0.556). No additional procedural factors (i.a. remaining intraventricular haematoma on pre-operative imaging, ventricular catheter position) to influence the shunt failure rate were identified. Conclusions Both the known literature and our current study cannot define a role for individual CSF counts of erythrocytes, leukocytes, protein and glucose in the occurrence of shunt failure. We recommend not to delay the first VPS implantation solely based on these markers in post aSAH patients.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Heidemans-Hazelaar, Drs. C.B. and van der Zwan, Prof. dr. A. |
| Faculty: | Medical Sciences |
| Date Deposited: | 08 Sep 2023 11:46 |
| Last Modified: | 08 Sep 2023 11:46 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3677 |
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