| Hemorrhagic Complications of Ventricular Puncture Procedure in Elderly Patients |
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Sang Kyun Kim , Hyun Chul Choi , In Bok Chang , Sung Ki Ahn , Joon Ho Song , Chul Bum Cho |
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Department of Neurosurgery, Hallym University College of Medicine, Sacred Heart Hospital, Kyung-Gi Do, Korea |
| 고령환자에서 뇌실 천자 시술과 관련된 출혈성 합병증 |
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김상균ㆍ최현철ㆍ장인복ㆍ안성기ㆍ송준호ㆍ조철범 |
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한림대학교 의과대학 신경외과학교실 |
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| Abstract |
Objective
Despite the widespread use of external ventricular drainage (EVD) and ventricular peritoneal shunt (V-P shunt), the frequency of associated hemorrhagic complications remains unclear. This study examined the frequency and risk factors of hemorrhagic complications of EVD and V-P shunt in elderly patients.
Methods
Treatment records from 73 elderly patients admitted during five-year period who required of EVD and V-P shunt were reviewed. We included in this retrospective study all patients who underwent EVD and V-P shunt at the Hallym University Sacred Heart Hospital between January 2006 and December 2010 were evaluated for catheter-associated hemorrhage. Computed tomographic scans after catheter insertion were obtained on all patients from immediate postoperative period to last follow up period. Patient age, sex, Glasgow coma scale, operative title, ventricle entry point, catheter thickness, preoperative intracranial hemorrhage (ICH), preoperative intraventricular hemorrhage (IVH), preoperative hydrocephalus, operative goal, antiplatelet agent medication and past medical history were analyzed.
Results
The incidence of EVD and V-P shunt related hemorrhage was 23.3%. However, the incidence of detectable changes in the clinical neurological deficit was rare. A significant proportion of EVD and V-P shunt related hemorrhages were small and punctate. Operative title, ventricle entry point and operative goal have a significant correlation with hemorrhagic complication of ventricle puncture procedure.
Conclusion
Hemorrhagic complications of ventricle puncture procedure in elderly patients are more common than previously suspected. However the hemorrhages are rarely large and almost never require surgical procedure. Parieto-occipital ventricle entry point and V-P shunt have higher hemorrhagic complication after ventricle puncture procedure. |
| Key Words:
ComplicationㆍHemorrhageㆍVentricleㆍPunctureㆍIntracerebralㆍIntraventricularㆍElderly |
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