Prognostic observation of ultra-early emergency embolizaltion and continuous lumbar drainage for high grade intracranial aneurysms

Abstract

Objective To observe the prognosis of patients with Hunt-Hess grade Ⅳ-Ⅴ of intracranial saccular aneurysms who were treated with ultra-early emergency embolization and continuous lumbar drainage. Methods The clinical date of 32 patients with Hunt-Hess grade Ⅳ-Ⅴ intracranial saccular aneurysm (grade Ⅳ, n=24 and grade Ⅴ, n=8) admitted from January 2014 to December 2017 were analyzed retrospectively. Sixteen cases of them were treated with ultra-early emergency embolization and continuous lumbar drainage (group A) and 16 underwent emergency embolization (group B). The neurological prognosis of the patients was evaluated at 1, 3 and 6 months after treatment. According to head CT, TCD and clinical manifestation of postoperative patients, we determined whether there were cerebrovascular spasm, hydrocephalus and cerebral infarction, and counted the hospitalization time of the two groups. Results Group A has 5 patients with cerebral vasospasm, 9 patients with hydrocephalus, 6 patients with cerebral infarction and patients were in hospital for (25±8) d. Group B has 8 patients with cerebral vasospasm, 11 patients with hydrocephalus, 9 patients with cerebral infarction and patients were in hospital for (28±9) d. There was no significant difference in GCS between the group A and group B at 1 month after treatment (P>0.05); but there was significant difference in Rankin prognostic scores at 3 and 6 months after treatment between the 2 groups (P<0.05). Conclusion Ultra-early emergency embolization and continuous lumbar drainage can reduce the number of patients of cerebral vasospasm, hydrocephalus and cerebral infarction, and reduce the time of hospitalization, and improve the recovery level of 3 months and half a year after treatment. Key words: High grade subarachnoid hemorrhage; Intracranial aneurysms; Continuous lumbar drainage; Interventional therapy