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Continuous lumbar drain is a frequently practiced procedure to prevent cerebrospinal fluid (CSF) infection in post-operative neurosurgical cases. However, the level of CSF drained must correspond to the intracranial pressures, where any accidental increase in lumboventricular gradient by slipping of the drainage bag below the level of the iliac crest can lead to over drainage and catastrophe. The learning point is to use automated or manual measures to monitor Intra-Cranial Pressure (ICP) and sound alarm in such an event to prevent sagging of the brain.
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- Staykov D, Speck V, Volbers B, et al. Early recognition of lumbar overdrainage by lumboventricular pressure gradient. Neurosurgery. 2011;68(5):1187-1191. DOI: 10.1227/NEU.0b013e31820c0274
- Kawahara I, Tsutsumi K, Matsunaga Y, et al. Early awareness of cerebrospinal fluid hypovolemia after craniotomy for microsurgical aneurysmal clipping. Acta Neurochir. 2013;155(8):1543-1548. DOI: 10.1007/s00701-013-1755-4
- Morgan B. Setup and use of codman drainage unit for lumbar csf/icp monitoring. LHSC. https://www.lhsc.on.ca/critical-caretrauma-centre/setup-and-use-of-codman-drainage-unit-for-lumbarcsf/icp-monitoring. Published February 1, 2021. Accessed June 16, 202
- Brudder N, Ravussin P. Supratentorial masses: anesthetic considerations. In: Cottrell JE, Young WL, eds. Cottrell's Neuroanesthesia. 5th ed. Mosby; 2010:184-202
- Sporns P, Schwindt W, Cnyrim C, et al. Undetected Dural Leaks Complicated by Accidental Drainage of Cerebrospinal Fluid (CSF) can Lead to Severe Neurological Deficits. Rofo. 2016;188(05):451- 458. DOI: 10.1055/s-0035-1567034
- Hernando O, John S. B, Irene R, et al. Subarachnoid lumbar drains: A case series of fractured catheters and a near miss. Can J Anesth. 2007; 54(10):829–834. DOI: 10.1007/bf03021711
- Michali-Stolarska M, Bladowska J, Stolarski M, et al. Diagnostic imaging and clinical features of intracranial hypotension - review of literature. Pol J Radiol. 2017;82:842-849. DOI: 10.12659/PJR.904433