Chonnam Med J.  2013 Dec;49(3):113-117. 10.4068/cmj.2013.49.3.113.

Factors Related to Catheter-Induced Hemorrhage after Brain Parenchymal Catheterization

Affiliations
  • 1Department of Neurosurgery, Kwangju Christian Hospital, Gwangju, Korea. damianus1@naver.com

Abstract

This article aimed to investigate the incidence rate and possible risk factors for catheter-induced hemorrhage (CIH) after brain parenchymal catheterization. Between January 2011 and March 2013, 381 patients (572 punctures) who underwent brain parenchymal catheterization were retrospectively evaluated. All patients were checked by computerized tomography scan for the detection of hemorrhage within 48 hours after catheter insertion. CIH was defined as any evidence of new hemorrhage on the post-procedural computerized tomography scan. The incidence rate and the possible risk factors were analyzed by surgeon (4 different surgeons performed the procedures), characteristics of the catheter device, and patient background. Of 381 patients, 572 punctures were performed and CIH developed in 122 puncture cases (122/572, 21.3%). The risk factors related to CIH were Glasgow Coma Scale (GCS) score < or =8 (p<0.01) and prothrombin time international normalized ratio (PT INR) > or =1.3 (p=0.038). The amount of hemorrhage was minimal without additional operations. A low GCS score and high PT INR are implicated as potential risk factors for CIH after brain parenchymal catheterization. Careful and delicate operative technique can help to reduce postoperative complications in these patients.

Keyword

Drainage; Cerebral Hemorrhage; Brain; Catheterization

MeSH Terms

Brain*
Catheterization*
Catheters*
Cerebral Hemorrhage
Drainage
Glasgow Coma Scale
Hemorrhage*
Humans
Incidence
International Normalized Ratio
Postoperative Complications
Prothrombin Time
Punctures
Retrospective Studies
Risk Factors

Figure

  • FIG. 1 Axial CT scan obtained after catheterization. (A) Minimal hemorrhage is shown along the catheter, demonstrating a small hemorrhage (1-5 cc) (B) and a hemorrhage of more than 5 cc (C).


Reference

1. Narayan RK, Kishore PR, Becker DP, Ward JD, Enas GG, Greenberg RP, et al. Intracranial pressure: to monitor or not to monitor? A review of our experience with severe head injury. J Neurosurg. 1982; 56:650–659.
2. Sundbärg G, Nordström CH, Söderström S. Complications due to prolonged ventricular fluid pressure recording. Br J Neurosurg. 1988; 2:485–495.
Article
3. Pfausler B, Spiss H, Beer R, Kampl A, Engelhardt K, Schober M, et al. Treatment of staphylococcal ventriculitis associated with external cerebrospinal fluid drains: a prospective randomized trial of intravenous compared with intraventricular vancomycin therapy. J Neurosurg. 2003; 98:1040–1044.
Article
4. Dandy WE. Ventriculography following the injection of air into the cerebral ventricles. Ann Surg. 1918; 68:5–11.
Article
5. Hassler W, Zentner J. Ventricle puncture for external CSF drainage and pressure measurement using a modified puncture needle. Acta Neurochir (Wien). 1988; 94:93–95.
Article
6. Gardner PA, Engh J, Atteberry D, Moossy JJ. Hemorrhage rates after external ventricular drain placement. J Neurosurg. 2009; 110:1021–1025.
Article
7. Zabramski JM, Whiting D, Darouiche RO, Horner TG, Olson J, Robertson C, et al. Efficacy of antimicrobial-impregnated external ventricular drain catheters: a prospective, randomized, controlled trial. J Neurosurg. 2003; 98:725–730.
Article
8. Huh J, Joo WI, Chough CK, Park HK, Lee KJ, Rha HK. Hemorrhagic complications induced by external ventricular draining catheters. Korean J Cerebrovasc Surg. 2011; 13:256–262.
9. Kothari RU, Brott T, Broderick JP, Barsan WG, Sauerbeck LR, Zuccarello M, et al. The ABCs of measuring intracerebral hemorrhage volumes. Stroke. 1996; 27:1304–1305.
Article
10. Maniker AH, Vaynman AY, Karimi RJ, Sabit AO, Holland B. Hemorrhagic complications of external ventricular drainage. Neurosurgery. 2006; 59:4 Suppl 2. ONS419–ONS424. discussion ONS 424-5.
Article
11. Wheeler AP, Bernard GR. Treating patients with severe sepsis. N Engl J Med. 1999; 340:207–214.
Article
12. Laroche M, Kutcher ME, Huang MC, Cohen MJ, Manley GT. Coagulopathy after traumatic brain injury. Neurosurgery. 2012; 70:1334–1345.
Article
Full Text Links
  • CMJ
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr