Journal of Neurosurgical Sciences 2020 Dec 09

DOI: 10.23736/S0390-5616.20.05187-5

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Delayed subdural fluid collections after Ommaya reservoir placement

Ronald J. BENVENISTE ¹ ✉, Sunil G. IYER ², Aria M. JAMSHIDI ¹

¹ Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, FL, USA; ² Department of Hematology/Oncology, University of Miami Miller School of Medicine, 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 in order 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 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: Ommaya reservoir; Subdural hematoma; Intrathecal chemotherapy