{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T01:08:04Z","timestamp":1790644084715,"version":"4.1.0"},"reference-count":23,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>Initiation of external CSF drainage has been associated with a significant increase in rebleeding probability after aneurysmal subarachnoid hemorrhage (aSAH). However, the implications for acute management are uncertain. The purpose of this study was to evaluate the role of the amount of drained CSF on aneurysmal rebleeding.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Consecutive patients with aSAH were analyzed retrospectively. Radiologically confirmed cases of aneurysmal in-hospital rebleeding were identified and predictor variables for rebleeding were retrieved from hospital records. Clinical predictors were identified through multivariate analysis, and logistic regression analysis was performed to ascertain the cutoff value for the rebleeding probability.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>The study included 194 patients. Eighteen cases (9.3%) of in-hospital rebleeding could be identified. Using multivariate analysis, in-hospital rebleeding was significantly associated with initiation of CSF drainage (p = 0.001) and CSF drainage volume (63 ml [interquartile range (IQR) 55\u201369 ml] vs 25 ml [IQR 10\u201335 ml], p &lt; 0.001). Logistic regression showed that 58 ml of CSF drainage within 6 hours results in a 50% rebleeding probability. The relative risk (RR) for rebleeding after drainage of more than 60 ml in 6 hours was 5.4 times greater compared with patients with less CSF drainage (RR 5.403, 95% CI 2.481\u201311.767; p &lt; 0.001, number needed to harm = 1.687).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Volume of CSF drainage was highly correlated with the probability of in-hospital aneurysmal rebleeding. These findings suggest that the rebleeding probability can be affected in acute management should the placement of an external ventricular catheter be necessary. This finding necessitates meticulous control of the amount of drained CSF and the development of a definitive treatment protocol for this group of patients.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2017.2.jns162748","type":"journal-article","created":{"date-parts":[[2017,8,11]],"date-time":"2017-08-11T13:59:37Z","timestamp":1502459977000},"page":"1778-1784","source":"Crossref","is-referenced-by-count":23,"title":["Volume of cerebrospinal fluid drainage as a predictor for pretreatment aneurysmal rebleeding"],"prefix":"10.3171","volume":"128","author":[{"given":"Jasper H.","family":"van Lieshout","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Medical Faculty, Heinrich-Heine University D\u00fcsseldorf, Germany; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ina","family":"Pumpl\u00fcn","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical Faculty, Heinrich-Heine University D\u00fcsseldorf, Germany; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Igor","family":"Fischer","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical Faculty, Heinrich-Heine University D\u00fcsseldorf, Germany; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel A.","family":"Kamp","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical Faculty, Heinrich-Heine University D\u00fcsseldorf, Germany; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan F.","family":"Cornelius","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical Faculty, Heinrich-Heine University D\u00fcsseldorf, Germany; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans J.","family":"Steiger","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical Faculty, Heinrich-Heine University D\u00fcsseldorf, Germany; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hieronymus D.","family":"Boogaarts","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Radboud University Medical Center, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athanasios K.","family":"Petridis","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical Faculty, Heinrich-Heine University D\u00fcsseldorf, Germany; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerim","family":"Beseoglu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical Faculty, Heinrich-Heine University D\u00fcsseldorf, Germany; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"8","key":"b1","series-title":"Cochrane Database Syst Rev","article-title":"Antifibrinolytic therapy for aneurysmal subarachnoid haemorrhage","author":"Baharoglu MI","unstructured":"Baharoglu MI, Germans MR, Rinkel GJ, Algra A, Vermeulen M, van Gijn J, : Antifibrinolytic therapy for aneurysmal subarachnoid haemorrhage. 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