Lumbar drainage and delayed @entity2806 in XXXX :a systematic review.

@entity1 @entity2553 @entity2806 @entity510
INTRODUCTION: Lumbar drainage for cerebrospinal fluid (CSF) diversion in @entity510 ( @entity510 ) has been reported to be beneficial in small series. There is no consensus regarding the optimal candidates for lumbar drainage, timing of drain placement, or amount and duration of CSF drainage. METHODS: We performed a comprehensive review of the English literature reporting series of @entity1 with @entity510 undergoing CSF diversion with lumbar drains. Favorable clinical outcome was defined as modified Rankin Scale of 0--2 or Glasgow Outcome Scale as 4--5. RESULTS: A total of 8 studies reporting on 841 @entity1 were included. Of these, 446 @entity1 were treated with lumbar drains. Two studies were prospective and five studies had comparison groups. Most @entity1 undergoing lumbar drainage were in good clinical grade on presentation (394/446, 88%) and the majority had substantial clot burden on head CT. Among the five studies with a comparison group, lumbar drainage was associated with lower rates of symptomatic @entity2553 or delayed @entity2806 (20% vs 45%, p<0.001) and higher rates of favorable outcome (79.4% vs. 60.4% p<0.001). The complication rate was 3.5%. CONCLUSION: Lumbar drainage in @entity510 appears to be safe and associated with reduced rates of symptomatic @entity2553 and improved clinical outcomes in @entity1 in good clinical grade with thick clot burden, but the quality of most available studies is weak. The optimal duration and rate of CSF diversion remains uncertain.
