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首页> 外文期刊>British journal of neurosurgery >The frequency and severity of intracranial hypotension post-intraoperative lumbar drainage using a Tuohy needle and the traditional needle
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The frequency and severity of intracranial hypotension post-intraoperative lumbar drainage using a Tuohy needle and the traditional needle

机译：术中使用Tuohy针和传统针头进行腰椎引流​​术后颅内低血压的频率和严重程度

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Background Intraoperative lumbar cerebrospinal fluid (CSF) drainage is a well-recognised technique in cranial and vascular surgery. The goal of the study was to assess the frequency and severity of intracranial hypotension post-intraoperative lumbar drainage performed using two different techniques, a 14G Tuohy needle versus an 18G traditional needle. Methods The medical records and imaging studies of 94 patients who had undergone open cranial operation were retrospectively studied: 47 patients had intraoperative lumbar drainage and 47 patients did not. A 14G Tuohy needle was employed in 27 (57.4%) patients and an 18G traditional needle was employed in 20 (42.6%) patients. Results There were signs of intracranial hypotension on MR images in nine (19.1%) patients who had intraoperative lumbar CSF drainage; none of the patients in the control group exhibited the MR signs of intracranial hypotension. A 14G needle was used in 6/9 patients and resulted in severe complications: one patient developed a delayed intracranial epidural hematoma that required emergency evacuation and a blood patch. Another patient developed somnolence that required two epidural blood patches and a third patient had protracted headaches. The 18G needle was used in the remaining 3/9 patients who were asymptomatic or presented with mild headaches. Conclusion The use of the smaller 18G traditional needle was associated with better outcomes with regards to intracranial hypotension, and the frequency of severe complications was higher with the use of the 14G Tuohy needle.
机译：背景术中腰脑脊液（CSF）引流是颅脑和血管外科手术中公认的技术。该研究的目的是评估使用两种不同技术进行的颅内低血压在术中腰椎引流后的频率和严重性，一种是14G Tuohy针还是一种18G传统针。方法回顾性分析94例行开颅手术的患者的病历和影像学资料：47例行术中腰椎引流，47例未行腰椎引流​​。 27例（57.4％）患者使用了14G Tuohy针，而20例（42.6％）患者使用了18G传统针。结果9例（19.1％）术中腰CSF引流患者的MR图像有颅内低血压的征象。对照组中没有患者表现出颅内低血压的MR征象。在6/9的患者中使用了14G针头，并导致了严重的并发症：一名患者发展为延迟性颅内硬膜外血肿，需要紧急疏散和补血。另一位患者出现嗜睡症，需要两次硬膜外血液修补，第三位患者长期头痛。其余3/9无症状或轻度头痛的患者使用18G针头。结论使用较小的18G传统针头可以降低颅内低血压，并且使用14G Tuohy针可以提高严重并发症的发生率。

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