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ORIGINAL ARTICLE
Journal of Neurosurgical Sciences 2023 June;67(3):324-30
DOI: 10.23736/S0390-5616.20.05187-5
Copyright © 2020 EDIZIONI MINERVA MEDICA
language: English
Delayed subdural fluid collections after Ommaya reservoir placement
Ronald J. BENVENISTE 1 ✉, Sunil G. IYER 2, Aria M. JAMSHIDI 1
1 Miller School of Medicine, Department of Neurosurgery, University of Miami, Miami, FL, USA; 2 Miller School of Medicine, Department of Hematology and Oncology, University of Miami, Miami, FL, USA
BACKGROUND: Delayed subdural fluid collections can occur after Ommaya reservoir placement and can cause neurological symptoms and interfere with treatment. We performed a retrospective chart review to study risk factors for delayed subdural fluid collections and clinical outcomes.
METHODS: Retrospective chart review was performed for patients undergoing Ommaya reservoir placement between 2010-2019 at our institution.
RESULTS: Out of 53 patients who had Ommaya reservoir placement during the study period, 11 developed delayed subdural fluid collections (21%). HIV infection was the only statistically significant risk factor (P=0.001, Fisher’s Exact Test). Thrombocytopenia, ventricle size, use of the reservoir, and suboptimal catheter placement were not associated with development of delayed subdural fluid collections. 2 patients, both HIV positive, required surgical evacuation.
CONCLUSIONS: Delayed subdural fluid collections occur in a significant minority of patients after Ommaya reservoir placement, and some patients require surgical intervention. HIV infection is associated with a higher risk of development of delayed subdural fluid collections. This patient subpopulation may benefit from closer monitoring or adjustment of management protocols.
KEY WORDS: Hematoma, subdural; Drug therapy; Subdural effusion