Case Report, J Spine Neurosurg Vol: 10 Issue: 3
The Application of Carotid Cistern Drainage in Neurosurgery
Purpose: This paper introduces a safe, effective and convenient method of Cerebrospinal Fluid (CSF) drainage. A very soft, elastic, small lumbar cisterna drainage tube is used, which is conveniently placed into the basilar cisterna (carotid cisterna, etc.) during craniotomy. Drainage of CSF from the basal cistern is of great significance in craniotomy, it plays a positive role in controlling intracranial pressure, excluding bloody cerebrospinal fluid, reducing the incidence of cerebrospinal fluid leakage, and alleviating headache and other symptoms of patients. Because the tip of the drainage tube is round and blunt, the diameter will not exceed 1.5 mm and the surface is smooth, it will not damage the peripheral blood vessels and nerves when placed into the basal cistern of the brain, so it is very safe. Methods: After intracranial surgery, such as aneurysm clipping, traumatic or spontaneous hematoma removal and intracranial tumor resection, the basal cistern (carotid cistern, suprasellar cistern, endplate cistern, cerebellopontine angle cistern, etc.) was opened near the operation area after intracranial surgery, and a drainage tube was placed to continuously drain cerebrospinal fluid through skin tunnel for 2-5 days to control postoperative intracranial hypertension and reduce postoperative complications. Results: 36 cases of intracranial surgery were treated with basal cistern cerebrospinal fluid drainage, including 12 cases of intracranial aneurysm clipping, 14 cases of intracranial hematoma clearance, and 10 cases of intracranial tumor resection. During the operation, the basilar cistern was exposed under the microscope, the arachnoid membrane was opened and the drainage tube was placed smoothly. The postoperative drainage of CSF was smooth, and the intracranial pressure control effect was satisfactory. The headache symptoms of the patients were mild and the recovery was fast. Conclusion: This paper introduced 36 clinical cases, including clipping of intracranial aneurysm, resection of skull base tumor, and removal of traumatic or spontaneous intracranial hemorrhage, this method has achieved satisfactory results. Continuous drainage of cerebrospinal fluid from carotid cistern plays a positive role in controlling intracranial hypertension, improving symptoms and prognosis after cranio cerebral surgery. Through four typical cases, described in detail the way of drainage tube placement and matters needing attention, and discussed with reference to the literature.