Publication year: 2012
Source:World Neurosurgery
Qinghu Meng, Lin Wei, Xingang Li, Gang Li, Xueyuan Heng, Chengwei Wang, Chang Fei, Qinglin Zhang
Objective Current treatment of apnea due to acute tonsillar herniation is often inadequate. This study was undertaken to verify the clinical usefulness of normal saline injection via lumbar puncture for the treatment of apnea secondary to acute tonsillar herniation. Methods Between 1969 and 2009, a total of 45 patients, who had not regained spontaneous respiratory function after external ventricular drainage or removal of a supratentorial lesion via open craniotomy, received an injection of normal saline via lumbar puncture. Patient data was retrospectively analyzed. Results Eleven out of the 45 patients regained spontaneous breathing and recovered fully (24.4%). Sixteen patients regained spontaneous breathing but died later (35.6%), and a further eighteen patients did not regain spontaneous respiration (40.0%). The overall rate of effectiveness of injected normal saline was therefore 60.0%. Conclusion For patients with tonsillar hernia who did not regain spontaneous respiration after external ventricular drainage or removal of a supratentorial lesion, an aggressive approach may be considered. Injection of normal saline via lumbar puncture could improve outcome in some of these patients.
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