{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:36:22Z","timestamp":1787841382048,"version":"build-2784847793"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The outcome of poor grade subarachnoid hemorrhage (SAH) is dismal. Some of these patients need cerebrospinal fluid (CSF) drainage procedure for the hydrocephalus and intraventricular hemorrhage (IVH) which may precipitate rebleeding. However, aneurysmal rebleed following CSF drainage procedure is controversial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Our study aimed at analyzing the effect of CSF drainage procedure on aneurysmal rebleeding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods:<\/jats:title>\n                    <jats:p>We retrospectively analyzed the records of all the consecutive patients diagnosed with poor grade aneurysmal SAH over three year period. Patients initially requiring either external ventricular drainage (EVD) or lumbar drain (LD) were included in the study group, and the rest (not requiring drainage) were included in the control group. Rebleeding was confirmed on computed tomography. The factors affecting rebleeding were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Overall 194 patients with poor grade SAH were enrolled in the study (91 males: 103 females; mean age: 50.6 years). The study group had 91 patients (83 EVD and 8 LD) while 103 patients were in the control group. Posterior circulation aneurysms, poor grade SAH, hydrocephalus, and IVH were more common in the study group\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001. The rebleeding rate was 7.6% in the study group and 8.7% in the control group. On univariate analysis size &gt;1 cm, multiplicity, multilobularity, vasospasm, and CSF drainage were significant risk factors for rebleeding (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). On multivariate analysis aneurysm size &gt;1 cm, CSF overdrainage &gt;250 ml\/day were significantly associated with risk of rebleeding.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Ventricular drainage is essential to relieve acute hydrocephalus and drain IVH in SAH and we found no significant association between CSF drainage and rebleeding. However, rapid overdrainage of CSF can lead to aneurysm rupture, hence controlled controlled CSF drainage should be undertaken.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ni.ni_622_21","type":"journal-article","created":{"date-parts":[[2024,7,2]],"date-time":"2024-07-02T12:39:55Z","timestamp":1719923995000},"page":"572-577","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Incidence of Rebleed Following Cerebrospinal Fluid (CSF) Drainage in Poor Grade Subarachnoid Hemorrhage: An Institutional Experience"],"prefix":"10.4103","volume":"72","author":[{"given":"Dattaraj P.","family":"Sawarkar","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pankaj K.","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"HS","family":"Nandish","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajeev","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shweta","family":"Kedia","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajesh","family":"Meena","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajinder","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,6,30]]},"reference":[{"key":"R1-20260507","doi-asserted-by":"crossref","first-page":"14","DOI":"10.3171\/jns.1968.28.1.0014","article-title":"Surgical risk as related to time of intervention in the repair of intracranial aneurysms","volume":"28","author":"Hunt","year":"1968","journal-title":"J Neurosurg"},{"key":"R2-20260507","doi-asserted-by":"crossref","first-page":"1275","DOI":"10.1227\/01.NEU.0000093199.74960.FF","article-title":"Poor-grade aneurysmal subarachnoid hemorrhage: Outcome after treatment with urgent surgery","volume":"53","author":"Laidlaw","year":"2003","journal-title":"Neurosurgery"},{"key":"R3-20260507","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1080\/02688690120082387","article-title":"Trends over time in the management of subarachnoid haemorrhage in newcastle: Review of 1609 patients","volume":"15","author":"Ogungbo","year":"2001","journal-title":"Br J Neurosurg"},{"key":"R4-20260507","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1080\/02688690050004516","article-title":"Outcome from poor grade aneurysmal subarachnoid haemorrhage-which poor grade subarachnoid haemorrhage patients benefit from aneurysm clipping?","volume":"14","author":"Hutchinson","year":"2000","journal-title":"Br J Neurosurg"},{"key":"R5-20260507","first-page":"183","article-title":"Results of early surgery in poor-grade aneurysm patients","volume":"40","author":"Zentner","year":"1996","journal-title":"J Neurosurg Sci"},{"key":"R6-20260507","doi-asserted-by":"crossref","first-page":"37","DOI":"10.3171\/jns.1990.73.1.0037","article-title":"The International Cooperative Study on the timing of aneurysm surgery. 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