TY -的T1 - CSF转移在动脉瘤性蛛网膜下腔出血:我们应该多低?乔(S25.002) JF -首页神经-神经学六世- 82 - 10补充SP - S25.002盟詹妮弗Fugate AU - Alejandro Rabinstein盟Eelco Wijdicks AU -威廉·弗里曼盟朱塞佩Lanzino Y1 - 2014/04/08 UR - //www.ez-admanager.com/content/82/10_Supplement/S25.002.abstract N2 -目的:评估动脉瘤性蛛网膜下腔出血患者随机化的可行性(aSAH表示)和脑积水“积极”与“传统”脑脊液(CSF)排水。背景:外部心室下水道(evd格式)表示由于aSAH表示脑脊液引流对急性阻塞性脑积水。没有数据支持最优率或脑脊液引流时间。设计/方法:2,成人患者的前瞻性随机试验研究aSAH表示需要EVD急性脑积水。病人被随机分为:1)积极的脑脊液引流EVD开放5毫米汞柱,或2)常规CSF排水EVD开放15毫米汞柱。病人被随机分为EVD放置在24小时内。激进的手臂,EVD保持在5毫米汞柱7天直到断奶的审判可能尝试。EVD的患者在传统的手臂可以自由裁量权的断奶脑积水的临床治疗。按方案分析。 RESULTS: 20 patients were included; 13 patients in the aggressive group. Median age was 54 years (IQR 47-72). Aneurysm was treated by endovascular coiling in 15 (75%) and by surgical clipping in 5 (25%). Twelve patients (60%) were poor clinical grade (WFNS grade IV-V) at nadir, and 4 patients (20%) remained poor-grade following CSF drainage. In the aggressive group, there was a trend towards more daily CSF output (median 220 cc vs 187 cc, p=0.09) and higher rate of ventriculoperitoneal shunt placement [n=10,( 77%) vs. 2 (29%), p=0.06). Duration of EVD placement was longer in the aggressive arm [median 11.5 days (IQR 7-15) vs. 8 days (8-15), p=0.53]. CONCLUSIONS: Randomizing aSAH patients with acute hydrocephalus to different degrees of CSF diversion is feasible. Results from this small pilot study suggest that a more aggressive approach to CSF diversion may be associated with higher rates of VP shunt placement, but this needs further investigation.Disclosure: Dr. Fugate has nothing to disclose. Dr. Rabinstein has received royalty payments from Elsevier and Oxford. Dr. Rabinstein has received research support from DJO Global. Dr. Wijdicks has received personal compensation in an editorial capacity for Neurocritical Care. Dr. Lanzino has nothing to disclose.Wednesday, April 30 2014, 2:00 pm-3:45 pm ER -