Work

Predictive Factors for Postoperative Cerebrospinal Fluid Drainage in Neurosurgical Management of Intracranial Aneurysms

Year: 2025

Type: article

Abstract: BACKGROUND: Management of intracranial aneurysms (IAs) often requires complex neurosurgical interventions, with some patients necessitating postoperative cerebrospinal fluid (CSF) drainage. Identifying predictive factors for CSF drainage can enhance patient outcomes through targeted interventions and improved perioperative care. METHODS: In this retrospective study, 151 patients who underwent surgical treatment for IAs were included. Demographic data, clinical presentation (Hunt-Hess grade and modified Fisher score), surgical details (operative time and intraoperative complications), and postoperative outcomes were reviewed. Both univariate and multivariable logistic regressions were conducted to identify predictors of postoperative CSF drainage. A subgroup analysis compared patients with anterior versus posterior circulation aneurysms. RESULTS: Overall, 67 patients required postoperative CSF drainage. On multivariable analysis, age ≥60 years, high Hunt-Hess grade, operative time >5 hours, and intraoperative aneurysm rupture significantly increased the odds of drainage (P < 0.05). Subgroup analysis revealed that these risk factors conferred an even higher likelihood of CSF drainage in posterior circulation aneurysms. Gender and modified Fisher score did not show significant associations with drainage. CONCLUSIONS: Advanced age, high Hunt-Hess grade, prolonged operative time, and intraoperative rupture predict postoperative CSF drainage in patients with IAs. Incorporating both global and subgroup-based risk assessments can help refine perioperative strategies to reduce complications and improve patient outcomes.

Source: World Neurosurgery

DOI: 10.1016/j.wneu.2025.123913

Author: Xiaohong Guo

Institution: Dongyang People's Hospital

Language: English

Topic: Intracranial Aneurysms: Treatment and Complications

Subfield: Neurology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,943