What is the primary purpose of external lumbar CSF drainage in the context of cerebral vasospasm prevention?
a) To directly remove blood from the brain's blood vessels.
b) To increase intracranial pressure.
c) To monitor CSF characteristics.
d) To administer calcium channel blockers.
Why is lowering intracranial pressure through CSF drainage beneficial in preventing cerebral vasospasm?
a) It reduces the risk of infection.
b) It prevents CSF leakage.
c) It decreases pressure on blood vessels in the brain.
d) It increases blood flow to the brain.
In addition to pressure reduction, what other information can be obtained from CSF analysis during lumbar drainage?
a) Hemoglobin levels.
b) Platelet count.
c) Red blood cell count and protein concentration.
d) Electrolyte levels.
How might external lumbar CSF drainage be used to administer medications in the context of cerebral vasospasm prevention?
a) Medications cannot be administered through CSF drainage.
b) Medications are injected directly into blood vessels.
c) Medications are infused into the CSF through the drainage system.
d) Medications are administered orally.
What is therapeutic volume expansion in the context of external lumbar CSF drainage?
a) The removal of CSF without replacement.
b) The replacement of CSF with blood.
c) The simultaneous removal of CSF and replacement with other fluids.
d) The use of external lumbar CSF drainage for diagnostic purposes only.
What are some potential risks associated with external lumbar CSF drainage?
a) Heart attack and stroke.
b) Infection, bleeding, and CSF leak.
c) Allergic reactions to medications.
d) Loss of consciousness.
What did the LUMAS trial find regarding the benefit of lumbar drainage in preventing cerebral vasospasm?
a) It confirmed the significant benefit of lumbar drainage.
b) It found no benefit of lumbar drainage.
c) It suggested that lumbar drainage might be beneficial in certain cases.
d) It recruited severely affected patients only.
What was the primary outcome measure in the EARLYDRAIN trial, and what did it find?
a) The primary outcome was CSF pressure reduction, which was not achieved.
b) The primary outcome was angiographic vasospasm, which was reduced.
c) The primary outcome was the modified Rankin Scale (mRS) score at 6 months, which showed improved outcomes with lumbar drainage.
d) The primary outcome was shunt-dependent hydrocephalus (SDHC) prevention, which was not affected by lumbar drainage.
According to the meta-analysis, which type of drainage (lumbar drainage or external ventricular drainage) had a better outcome in aneurysmal SAH patients?
a) Both had similar outcomes.
b) Lumbar drainage had a better outcome.
c) External ventricular drainage had a better outcome.
d) The meta-analysis did not provide a conclusion regarding outcomes.
What is the overall conclusion regarding the effectiveness of continuous CSF drainage for aneurysmal SAH patients, according to the meta-analysis?
a) Continuous CSF drainage is not effective in preventing vasospasm.
b) Lumbar drainage is the most effective method for preventing vasospasm.
c) Continuous CSF drainage is an effective treatment for aneurysmal SAH patients.
d) Further research is needed to determine the effectiveness of continuous CSF drainage.
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