Hemorrhagic Stroke: Post External Ventricular Drainage Evolution
Rasolonjatovo EC1*, Mampiandranosy TH1, Rakotovao KT1, Tsiaremby MG1, Ratovondrainy W2, Rabarijaona M3 and Andriamamonjy C1
1Department of Neurosurgery University Hospital Joseph Ravoahangy
Andrianavalona, Antananarivo
2Department of Neurosurgery Hospital Center Soavinandriana, Antananarivo
3Department of Neurosurgery University Hospital Tambohobe Fianarantsoa
*Corresponding Author: RASOLONJATOVO EC, Department of Neurosurgery
University Hospital Joseph Ravoahangy Andrianavalona, Antananarivo.
Received:
July 12, 2022; Published: October 10, 2022
Abstract
Introduction: A hemorrhagic stroke results in a sudden neurological deficit secondary to an eruption of blood in the cerebral parenchyma. External CSF drainage is indicated in cases of intracranial hypertension following acute hydrocephalus due to ventricular flooding.
Objective: Evoke the postoperative prognosis of hemorrhagic stroke treated by external ventricular bypass in the context of Madagascar
Materials and Methods: We conducted a descriptive retrospective study of 61 cases of hemorrhagic stroke treated by external ventricular drainage at the Neurosurgery and Surgical Resuscitation Department of the CHUJRA, between January 2018 and December 2020. The epidemio-clinical, computed tomographic, therapeutic and outcome parameters are described in order to identify the postoperative prognosis using the preoperative ICH score.
Results: The average age of the patients was 55.09 years with a majority in the age groups of 44 to 65 years. There is a slight male predominance. The symptomatology is dominated by the motor deficit syndrome like hemiplegia in 73.77% of the patients, then the syndrome of intracranial hypertension in 34.42%. The main risk factor was high blood pressure (93.44%) followed by alcohol and smoking (50.81%). Brain computed tomography showed ventricular flooding with acute hydrocephalus in 75% of cases. Fifty-one patients (83.61%) had an ICH score between 2 and 3. The used surgical technique was external drainage of CSF with or without hematoma evacuation. Among the postoperative complications (52.45% of cases), CSF infection is the most common (39.34%) followed by mechanical complications (25%). The mortality rate was 52.45%. Mortality factors were associated with severe initial impaired consciousness, a high ICH score greater than or equal to 3 and infections (pleuropulmonary and meningitis).
Conclusion: Morbi-mortality due to hemorrhagic stroke remains high in this study. External drainage of CSF has its place in emergency treatment. Prevention and treatment of CSF infection remains a real challenge.
Keywords:Hemorrhagic Stroke; External Drainage of Cerebrospinal Fluid; Hydrocephalus; Meningitis
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