A Randomised Controlled Trial of Lumbar Drainage to Treat Communicating Hydrocephalus After Severe Intraventricular Hemorrhage
A Randomised Controlled Trial of Lumbar Drainage to Treat Communicating Hydrocephalus After Severe Intraventricular Hemorrhage
The purpose of this study is to determine if usage of early lumbar drainage leads to less
 shunt surgery and less catheter associated complications in patients with communicating
 hydrocephalus after intracerebral hemorrhage with severe ventricular involvement.
All patients requiring external ventricular drain (EVD) for treatment of acute obstructive
 hydrocephalus receive intraventricular fibrinolysis with rt-PA via the ventricular catheter.
 Lumbar drainage (LD) is inserted at a timepoint, when communication between the internal and
 the external CSF-spaces is recognizable on CT ("opening" of third and fourth ventricle and
 aqueduct).
Inclusion Criteria:

 -  supratentorial intracerebral hemorrhage <60ml

 -  intraventricular hemorrhage with casting of the third and fourth ventricles

 -  obstructive hydrocephalus with need of external ventricular drainage

 -  GCS <9 on admission or within 48h of symptom onset

 -  admission within 48h of symptom onset

 -  preceding modified Rankin scale ≤3

 -  age 18-85 years

 Exclusion Criteria:

 -  ICH related to oral anticoagulation, trauma, tumor, arteriovenous malformation,
 aneurysm, systemic thrombolysis or sinus thrombosis

 -  infratentorial hemorrhage

 -  pregnancy

 -  admission 48h after symptom onset

 -  preceding modified Rankin scale >3