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  4. Vol 7, Issue 3, 2026

Effects of lumbar puncture and lumbar cistern drainage on postoperative cerebrospinal fluid parameters and clinical prognosis in patients with aneurysmal subarachnoid hemorrhage

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DOI: 10.23977/medsc.2026.070306 | Downloads: 1 | Views: 15

Author(s)

Lei Yang 1, Xiong Yang 1, Ben Tan 1, Xiaoming Wei 1, Qingqing Zhou 1

Affiliation(s)

1 Department of Neurosurgery, First People's Hospital of Jingzhou, Jingzhou, Hubei, 434000, China

Corresponding Author

Lei Yang

ABSTRACT

This study aims to compare the effects of lumbar puncture (LP) and lumbar cistern drainage (LD) on cerebrospinal fluid parameters and clinical outcomes in postoperative aSAH patients, and to identify prognostic risk factors. A retrospective analysis was conducted on clinical data of 98 patients who underwent cerebrospinal fluid drainage after aSAH, including 65 cases in the LP group and 33 cases in the LD group. Baseline characteristics, cerebrospinal fluid pressures, white blood cell counts, red blood cell counts, lactate dehydrogenase (LDH) levels, protein levels on days 1, 3, and 7 postoperatively, as well as the rate of favorable prognosis (mRS scores 0–2) at discharge were compared between the two groups. Univariate and multivariate logistic regression analyses were performed to identify independent prognostic risk factors. No statistically significant differences were observed in baseline characteristics between the two groups (P > 0.05). On day 1 postoperatively, the LD group exhibited significantly higher values for cerebrospinal fluid white blood cells [472.5×106/L vs. 118×106/L], red blood cells [268×109/L vs. 148×109/L], LDH [57 U/L vs. 30 U/L], and protein [3.09g/L vs. 0.89g/L] compared to the LP group (P < 0.05). At days 3 and 7 postoperatively, no statistically significant differences were observed in any cerebrospinal fluid parameters between the groups (P > 0.05). The favorable prognosis rate was higher in the LP group (86.2%, 56/65) than in the LD group (69.7%, 23/33), but the difference was not statistically significant (P = 0.051). Univariate analysis revealed that the poor-prognosis group exhibited higher ages, greater proportions of Hunt-Hess grades III–V and Fisher grades 3–4, as well as elevated levels of white blood cells, red blood cells, LDH, and protein in cerebrospinal fluid on days 1 and 3 postoperatively (P < 0.05). Multivariate logistic regression analysis demonstrated that cerebrospinal fluid LDH levels on day 3 postoperatively were an independent risk factor for poor prognosis (OR = 1.015, 95% CI: 1.002–1.029, P < 0.05). Both lumbar puncture and lumbar cistern drainage demonstrate favorable safety profiles for cerebrospinal fluid drainage following aortic subarachnoid hemorrhage (aSAH). Elevated cerebrospinal fluid LDH levels on day 3 postoperatively represent an independent risk factor for poor prognosis, and dynamic monitoring of LDH levels aids in early identification of high-risk patients. The prognostic impact of these two drainage approaches requires further validation through prospective studies.

KEYWORDS

Aneurysmal subarachnoid hemorrhage; Lumbar puncture; Lumbodural pool drainage; Cerebrospinal fluid; Lactate dehydrogenase; Prognosis

CITE THIS PAPER

Lei Yang, Xiong Yang, Ben Tan, Xiaoming Wei, Qingqing Zhou. Effects of lumbar puncture and lumbar cistern drainage on postoperative cerebrospinal fluid parameters and clinical prognosis in patients with aneurysmal subarachnoid hemorrhage. MEDS Clinical Medicine (2026). Vol. 7, No. 3, 38-47. DOI: http://dx.doi.org/10.23977/medsc.2026.070306.

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