Combination of Conventional EVD and Ommaya Drainage for Intraventricular Hemorrhage (IVH)

Abstract

Tongming Zhu,1,* Junyan Fu,2,* Di Zang,1,3,* Zhe Wang,1,4,* Xiangru Ye,1 Xuehai Wu,1 Jin Hu1 1Department of Neurosurgery, Fudan University Huashan Hospital, National Center for Neurological Disorders, National Key Laboratory for Medical Neurobiology, Shanghai Key Laboratory of Brain Function and Regeneration, Institutes of Brain Science, MOE Frontiers Center for Brain Science, Shanghai Medical College-Fudan University, Shanghai, People’s Republic of China; 2Department of Radiology, Fudan University Huashan Hospital, Shanghai, People’s Republic of China; 3Department of Neurosurgery, China-Japan Friendship Hospital, Beijing, People’s Republic of China; 4Department of Medical Imaging Technology, SJTU-Ruijin-UIH Institute for Medical Imaging Technology, Shanghai, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xuehai Wu; Jin Hu, Department of Neurosurgery, Fudan University Huashan Hospital, No. 12, Middle Wulumuqi Road, Shanghai, People’s Republic of China, Email [email protected]; [email protected]: The effect of Ommaya reservoirs on the clinical outcomes of patients with intraventricular hemorrhage (IVH) remains unclear.Objective: We aimed to determine the effect of combining the Ommaya reservoir and external ventricular drainage (EVD) therapy on IVH and explore better clinical indicators for Ommaya implantation.Methods: A retrospective analysis was conducted on patients diagnosed with IVH who received EVD-Ommaya drainage between January 2013 and March 2021. The patient population was divided into two groups: the Ommaya-used group, comprising patients in whom the Ommaya drainage system was activated post-surgery, and the Ommaya-unused group, comprising patients in whom the system was not activated. The study analyzed clinical, imaging, and outcome data of the patient population.Results: A total of 123 patients with IVH were included: 75 patients in the Ommaya-used group and 48 patients in the Ommaya-unused group. The patients in the Ommaya-used group showed a lower 3-month GOS than those in the Ommaya-unused group (p 0.05). The GCS in the Ommaya-unused group was significantly lower than that in the other group, and there was a close correlation between the GCS and 3-month GOS (p< 0.0001). The GCS score showed significance in predicting the use of Ommaya (p< 0.001).Conclusion: The study demonstrated that combining EVD and Ommaya drainage was a safe and feasible treatment for IVH. Additionally, preoperative GCS was found to predict the use of Ommaya drainage in subsequent treatment, providing valuable information for pre-surgery decision-making.Keywords: intraventricular hemorrhage, Ommaya, external ventricular drainage

Keywords

• intraventricular hemorrhage
• ommaya
• external ventricular drainage