Application effect of two modalities for placing lumbar drain catheters in patients with postcraniotomy aseptic meningitis

Abstract

Aim: Aseptic meningitis is an unfortunate complication after craniotomy. Continuous lumbar drainage is a safe and effective method for treating postcraniotomy aseptic meningitis. This study compared the incidence of cerebrospinal fluid (CSF) leakage around the tube at the skin exit site and infection associated with tubes placed in two different ways. Patients and Methods: The study enrolled 140 consecutive patients with postoperative aseptic meningitis manifesting as headache and fever and managed by lumbar external drainage (LED) between June 2014 and July 2018. From June 2014 to Jan 2016, an LED catheter was set in a conventional fashion without a subcutaneous tunnel. From Feb 2016 to July 2018, we adopted a modified mode of placing the LED catheter with a subcutaneous tunnel. Drain-related CSF leakage and infection were analyzed between the two groups. Results: Postoperative aseptic meningitis can be easily managed through lumbar CSF drainage. The incidences of drain-associated infection and CSF leakage were 20% and 7.14%, respectively, in group 1 (without subcutaneous tunnels) and 7.14% and 4.28%, respectively, in group 2 (with subcutaneous tunnels). CSF leakage was significantly reduced in group 2 compared to group 1 (P < 0.05). The incidence of complications increased with the length of time that the drain remained in place. Conclusions: The use of a modified mode of lumbar catheter placement remarkably decreases the risk of CSF leakage and offers an ideal alternative to CSF drains. The duration of catheterization and placement method are risk factors for drain-associated infection and CSF leakage. Despite its potential benefits, the modified method still involves prolonged drainage.

Keywords

• Aseptic meningitis
• Leakage
• Infection