Effects of lumbar cerebrospinal fluid drainage on infection, rebleeding, clinical vasospasm, cerebral infarction, hydrocephalus and mortality among patients with aneurismal subarachnoid hemorrhage

  • Qizuan Chen Department of Neurosurgery, 900th Hospital, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou 350025, China; Department of Neurosurgery, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou 350025, China
  • Shangming Zhang Department of Neurosurgery, 900th Hospital, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou 350025, China; Department of Neurosurgery, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou 350025, China
  • Jiasheng Pei Department of Neurosurgery, 900th Hospital, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou 350025, China; Department of Neurosurgery, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou 350025, China
DOI: https://doi.org/10.62617/mcb1056
Keywords: subarachnoid hemorrhage; lumbar drainage; infection; rebleeding; vasospasm
Article ID: 1056

Abstract

Lumbar drainage (LD) has been proposed as a treatment to remove blood from the subarachnoid space in subarachnoid hemorrhage (SAH), but its effects on outcomes in aneurysmal SAH (aSAH) remain debated. This study analyzes the impact of continuous lumbar cerebrospinal fluid (CSF) drainage on infection, rebleeding, clinical vasospasm, cerebral infarction, hydrocephalus, and mortality in aSAH patients. A systematic search across PubMed, Web of Science, Embase, Elsevier Science Direct, and Springer Link identified 11 studies with 2059 patients for meta-analysis. The study evaluates the association between lumbar CSF drainage and clinical outcomes, considering how changes in intracranial pressure (ICP) and CSF dynamics may influence pathophysiology in aSAH. The pooled odds ratio (OR) for infection, rebleeding, clinical vasospasm, cerebral infarction, hydrocephalus, and mortality in the lumbar drainage group was 1.17 (95% CI: 0.81–1.70; P = 0.39), 0.75 (95% CI: 0.37–1.54; P = 0.44), 0.60 (95% CI: 0.48–0.75; P < 0.00001), 0.48 (95% CI: 0.35–0.64; P < 0.00001), 0.53 (95% CI: 0.22–1.24; P = 0.14), and 0.55 (95% CI: 0.36–0.84; P = 0.005), respectively, compared with the no-lumbar drainage group. Results indicate that lumbar CSF drainage does not significantly affect the occurrence of infection, rebleeding, or hydrocephalus. However, it reduces clinical vasospasm, cerebral infarction, and mortality, likely due to improved ICP management and enhanced cerebral perfusion. These findings suggest that continuous lumbar CSF drainage may benefit aSAH patients by mitigating ischemic injury, but further studies are needed to confirm its broader applicability and long-term effects on outcomes.

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Published
2025-01-15
How to Cite
Chen, Q., Zhang, S., & Pei, J. (2025). Effects of lumbar cerebrospinal fluid drainage on infection, rebleeding, clinical vasospasm, cerebral infarction, hydrocephalus and mortality among patients with aneurismal subarachnoid hemorrhage. Molecular & Cellular Biomechanics, 22(1), 1056. https://doi.org/10.62617/mcb1056
Issue
Vol. 22 No. 1 (2025)
Section
Article

Copyright (c) 2025 Qizuan Chen, Shangming Zhang, Jiasheng Pei

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