Efficacy of lamina terminalis fenestration in reducing shunt-dependent hydrocephalus following aneurysmal subarachnoid hemorrhage: a systematic review. Clinical article.

@article{Komotar2009EfficacyOL,
  title={Efficacy of lamina terminalis fenestration in reducing shunt-dependent hydrocephalus following aneurysmal subarachnoid hemorrhage: a systematic review. Clinical article.},
  author={Ricardo J. Komotar and David K. Hahn and Grace H. Kim and Robert M Starke and Matthew Clark Garrett and Maxwell B. Merkow and Marc L. Otten and Robert R. Sciacca and E. Sander Connolly},
  journal={Journal of neurosurgery},
  year={2009},
  volume={111 1},
  pages={
          147-54
        }
}
OBJECT Chronic hydrocephalus requiring shunt placement is a common complication following aneurysmal subarachnoid hemorrhage (SAH). Controversy exists over whether microsurgical fenestration of the lamina terminalis during aneurysm surgery affords a reduction in the development of shunt-dependent hydrocephalus. To resolve this debate, the authors performed a systematic review and quantitative analysis of the literature to determine the efficacy of lamina terminalis fenestration in reducing… 
The effect of fenestration of the lamina terminalis on the incidence of shunt-dependent hydrocephalus after aneurysmal subarachnoid hemorrhage (FISH)
TLDR
The FISH trial is a large randomized, parallel controlled clinical trial to define the therapeutic value of FLT, the results of which will help to guide the surgical procedure and resolve the long-puzzled debate in the neurosurgical community.
Reduction of shunt dependency rates following aneurysmal subarachnoid hemorrhage by tandem fenestration of the lamina terminalis and membrane of Liliequist during microsurgical aneurysm repair.
TLDR
Standem fenestration of the LT and MoL at the time of open microsurgical clipping and/or bypass to secure ruptured anterior and posterior circulation aneurysms is associated with reductions in shunt-dependent hydrocephalus following aSAH.
The Effect of Fenestration of Lamina Terminalis on the Vasospasm and Shunt-Dependent Hydrocephalus in Patients Following Subarachnoid Haemorrhage.
TLDR
Despite FLT can be a safe method there were not significant differences of FLT on the incidence of vasospasm and shunt-dependent hydrocephalus in ACoA aneurismal in SAH.
Effect of Microscopic Third Ventriculostomy (Lamina Terminalis Fenestration) on Shunt-needed Hydrocephalus in Patients with Aneurysmal Subarachnoid Hemorrhage.
TLDR
It is advised to plan and perform an RCT (randomized controlled trial) that can remove the confounding factors, match the groups, and illustrate the exact effect of LTF on shunt-needed hydrocephalus.
Efficacy of the Lamina Terminalis Fenestration Associated With the Liliequist Membrane Fenestration in Reducing Shunt-Dependent Hydrocephalus Following Aneurysm Surgery in the Acute Phase of Aneurysmal Subarachnoid Hemorrhage
TLDR
From January 2010 to January 2012, microsurgical fenestration of Lamina Terminalis and Liliequist’s Membrane was performed in 17 patients operated in the acute phase, and there was no development of hydrocephalus.
Lack of functional patency of the lamina terminalis after fenestration following clipping of anterior circulation aneurysms.
TLDR
Fenestration of the lamina terminalis did not result in functional patency when performed as part of surgical clipping for ruptured aneurysms, and the contrast agent followed the normal ventricular pathway from the lateral ventricles into the fourth ventricle, and did not appear in the basal cisterns.
Long-term functional outcomes and predictors of shunt-dependent hydrocephalus after treatment of ruptured intracranial aneurysms in the BRAT trial: revisiting the clip vs coil debate.
TLDR
There is no difference in shunt dependency after SAH among patients treated by endovascular or microsurgical means and patients in whom shunt-dependent hydrocephalus does not develop afterSAH tend to have improved long-term functional outcomes.
Shunt-dependent hydrocephalus after aneurysmal subarachnoid hemorrhage. A systematic review and meta-analysis.
TLDR
A systematic search into four databases identified several predictors of SDHC that can assist clinicians in monitoring patients with an aSAH and are a predictor of poor clinical outcome.
...
...

References

SHOWING 1-10 OF 23 REFERENCES
Microsurgical fenestration of the lamina terminalis reduces the incidence of shunt-dependent hydrocephalus after aneurysmal subarachnoid hemorrhage.
TLDR
Fenestration of the lamina terminalis appears to be associated with a decreased incidence of shunt-dependent hydrocephalus of more than 80% after aSAH, and this straightforward microsurgical maneuver should be performed whenever possible during aneurysm surgery.
Influence of Lamina Terminalis Fenestration on the Occurrence of the Shunt-Dependent Hydrocephalus in Anterior Communicating Artery Aneurysmal Subarachnoid Hemorrhage
TLDR
Surgeons should carefully decide the concomitant use of LT fenestration during surgery for the ruptured ACoA aneurysms because of the microsurgical fenESTration of LT can play a negative role in reducing the incidence of chronic hydrocephalus.
THE IMPACT OF MICROSURGICAL FENESTRATION OF THE LAMINA TERMINALIS ON SHUNT‐DEPENDENT HYDROCEPHALUS AND VASOSPASM AFTER ANEURYSMAL SUBARACHNOID HEMORRHAGE
TLDR
A retrospective single-surgeon series suggests that microsurgical fenestration of the lamina terminalis may not reduce the incidence of shunt-dependent hydrocephalus or cerebral vasospasm after aneurysmal subarachnoid hemorrhage.
Fenestration of the Lamina Terminalis as a Valuable Adjunct in Aneurysm Surgery
TLDR
FLT was associated with statistically significant decreases in shunting rates, incidence of vasospasm, and better outcomes, and is recommended for routine use in patients with Fisher Grade 3 anterior communicating artery aneurysmal SAH.
Does lamina terminalis fenestration reduce the incidence of chronic hydrocephalus after subarachnoid hemorrhage?
TLDR
Estimates from the most recently published studies indicate that an incidence of chronic post-subarachnoid hemorrhage hydrocephalus (requiring shunt surgery) of 15 to 20% is representative for an average contemporary population of patients with aneurysmal subarACHnoids hemorrhage.
The effects of fenestration of the interpeduncular cistern membrane arousted to the opening of lamina terminalis in patients with ruptured ACoA aneurysms: a prospective, comparative study
TLDR
This study shows that fenestration of the LM coupled with the opening of the LT reduced-relatively-the incidence of shunt-dependent chronic hydrocephalus (SDCH); this however was not significant.
Shunt-dependent hydrocephalus after rupture of intracranial aneurysms: a prospective study of the influence of treatment modality.
TLDR
Results of similar models indicated that among patients with intraventricular hemorrhage (IVH), surgical clip application carried a lower risk of shunt-dependent hydrocephalus compared with that for endovascular embolization.
Chronic shunt-dependent hydrocephalus after early surgical and early endovascular treatment of ruptured intracranial aneurysms.
TLDR
The results of the present study indicate that the treatment method used does not affect the risk of the later development of chronic shunt-dependent hydrocephalus.
Herniation Secondary to Critical Postcraniotomy Cerebrospinal Fluid Hypovolemia
TLDR
Severe cerebrospinal fluid hypovolemia after craniotomy may produce a dramatic herniation syndrome that is completely reversed by the Trendelenburg position, and brain sag should be included in the differential diagnosis for acute postoperative clinical deterioration in this patient population.
CSF hydrodynamics after subarachnoid hemorrhage
TLDR
Disturbed CSF‐hydrodynamics as one of the possible etiological factors of post‐SAH‐encephalopathy is discussed.
...
...