Case Series: Lumbar Cerebrospinal Fluid Drainage in Aneurysm Clipping
Abstract
Intracranial aneurysm rupture is a medical emergency often accompanied by subarachnoid hemorrhage (SAH), which requires immediate medical intervention to reduce the risk of morbidity and mortality. This case report provides an overview of lumbar cerebrospinal fluid drainage (LCFD) as a method to reduce increased intracranial pressure and prevent or treat hydrocephalus that can occur after SAH. It is done by inserting an epidural catheter in the subarachnoid lumbar. The effectiveness of LCFD is more significant in patients with MFS 3-4. This finding supports the use of LCFD in managing SAH aneurysm to improve patients’ prognosis. Management of this case involved meticulous preoperative evaluation, appropriate intraoperative intervention, and strict postoperative monitoring, including treatment of cerebral vasospasm that may arise as a complication of SAH. The results suggest that LCFD can successfully reduce complications and improve clinical outcomes in patients with ruptured aneurysms who have undergone aneurysm clipping. The success of this method emphasizes the importance of a multidisciplinary approach in the management of SAH to achieve optimal patient outcomes.
References
Tripathi P. Recent Advances in Anesthesiology. In: John AD, eds. Anesthesia: A Topical Update – Thoracic, Cardiac, Neuro, ICU, and Interesting Cases.. 2nd ed. Bentham Books. 2018:104–47. Doi: 10.2174/97816810872381180201
Butterworth IV JF, Mackey DC, Wasnick JD. Anesthesia for neurosurgery. In: Chestnut DA, Wong CA, Tsen LC, et al., editors. Morgan & Mikhail’s Clinical Anesthesiology. 7th ed. New York, NY: McGraw-Hill Education; 2022:966-1002. doi: 10.1036/9781260461884.
Pong RP, Lam AM. Anesthetic management of cerebral aneurysm surgery. In: Cottrell JE, Patel PM, Soriano SG, editors. Cottrell & Patel’s Neuroanesthesia. 7th ed. Philadelphia, PA: Elsevier; 2025:244–71. Doi: 10.1016/B978-0-323-93273-8.00013-4.
Longnecker DE, Mackey SC, Newman MF, Sandberg WS, Zapol W. Neuroanesthesia. In: Longnecker DE, Mackey SC, Newman MF, Sandberg WS, Zapol W, editors. Anesthesiology. 3rd ed. New York, NY: McGraw-Hill Education; 2017:807–47. Doi: 10.1036/9780071836511.
Wiercinski L, Christiansen C. Lumbar puncture and drainage. In: Wiercinski L, Christiansen C, editors. Interventional Critical Care. Cham: Springer; 2021:279–88. Doi: 10.1007/978-3-030-64661-5_27.
Wolf S, Mielke D, Barner C, Malinova V, Kerz T, Wostrack R, et al. Effectiveness of lumbar cerebrospinal fluid drain among patients with aneurysmal subarachnoid hemorrhage: A randomized clinical trial. JAMA Neurol. 2023;80(8):833–42. Doi: 10.1001/jamaneurol.2023.1792.
Kim DY, Cho YH, Kim S, Jeong JH, Choi JH, Kang M, et al. Feasibility of prompt lumbar drainage in patients with aneurysmal subarachnoid hemorrhage. World Neurosurg. 2023;175:e1032-e1040. Doi: 10.1016/j.wneu.2023.04.066.
Fang Y, Shao Y, Lu J, et al. The Effectiveness of Lumbar Cerebrospinal Fluid Drainage in Aneurysmal Subarachnoid Hemorrhage with Different Bleeding Amounts. Neurosurg Rev. 2020;43(2):739–47. doi: 10.1007/s10143-019-01116-1.
Copyright (c) 2026 Timor Krisna Bayu, Muhammad Yogi Prandani, Anisa Fadhila Farid, Bowo Adiyanto
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
The Contributor and the company/institution agree that all copies of the Final Published
Version or any part thereof distributed or posted by them in print or electronic format as permitted herein will include the notice of copyright as stipulated in the Journal and a full citation to the Journal.
