Effect of Lumbar Cistern Drainage on Plasma and CSF Endothelin Concentrations and Cerebral Vasospasm in Patients with Ruptured Aneurysm

Objective To investigate the effects of lumbar cistern drainage on endothelin(ET) concentrations in plasma and cerebral spinal fluid(CSF) and cerebral vasospasm in the patients with ruptured aneurysm. Methods Three hundred and fifty-four patients with ruptured aneurysms, which were embolized by coils, were divided into drainage (268 cases) and control (86 cases) groups. The lumbar cistern drainage was carried out in the drainage group and the CSF was discharged through a lumber puncture per day in the control group. The concentrations of ET in plasma and CSF were determined by radioimmunoassay and the mean velocity of blood flow of the middle cerebral artery (VMCA) was determined by transcranial color Doppler ultrasound at different time after the embolization. Results The plasma and CSF ET concentrations in the drainage group were significantly lower than those in the control group (P0.01) after the embolization. The VMCA in the drainage group was significantly slower than that in the control group (P0.01) after the embolization. The positive correlation (r=0.95, P0.01) was observed between ET and VMCA. Conclusions The cerebral vasospasm after the subarachnoid hemorrhage is positively related to the ET concentrations of plasma and CSF. The factors causing cerebral vasospasm can be removed by lumbar cistern drainage in the patients with ruptured aneurysm.[