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Ventricular irrigation in cases of cerebral ventriculitis; A prospective controlled study
EANS Academy. AlMenabbawy . Oct 23, 2018; 259720
Prof. Dr. Ahmed AlMenabbawy
Prof. Dr.  Ahmed AlMenabbawy
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Abstract
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Background
Ventriculitis is a challenging medical condition with usually poor outcome, a long course of treatment & hospital stay. The conventional current mainstay management is the administration of antibiotics in addition to cerebrospinal fluid drainage by means of an external ventricular drain.


Aim and abjectives: The aim of this study is to compare the outcome of ventricular lavage -either endoscopically or using two tubes for irrigation and drainage with the conventional line of treatment.

Patients and methods:
A prospective controlled study was conducted on 32 patients with ventriculitis which was in most of the cases a complication of CSF shunt operation. Both groups were managed by removal of the infected ventricular catheter whenever present (24/32 = 75% of all cases). The first group was managed by ventricular lavage either endoscopically or using two ventricular tubes for irrigation and drainage, while the other group was managed using the conventional therapy by inserting an external ventricular drain. Intravenous and intraventricular antibiotics were used in both groups. The outcomes were compared regarding mortality rate, Glasgow Outcome Scale and hospital stay duration.

Results
Patients' mean age was 73.97 months ± 15.19 [SE]. They were followed up to a mean duration of 6.37 months ± 3.65 [SE] months and a mortality rate of 25 % in the lavage group, 50% in the other group. Glasgow Outcome Scale was more than 4 (good outcome) in (10/16) 62.5 % of the lavage group cases and in (4/16) 25% in the conventional group. Mean hospital stay duration was 20.47 days ± 3.8 [SE] among the lavage group while it was 39.73 days ± 4.53 [SE] in the conventional group.

Conclusion:
Ventricular lavage is useful in the management of cerebral ventriculitis and is associated with better outcome and less hospital stay duration compared to current conventional lines of treatment.
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