Abstract
OBJECTIVES: To evaluate the Outcomes of Fenestration of Lamina Terminalis for Hydrocephalus following Clipping of Ruptured Aneurysms of Anterior Circulation. METHODS: A retrospective case series study was conducted at the Punjab Institute of Neurosciences, Lahore from August 2022 to July 2023. Seventy seven patients meeting the inclusion criteria of age group 20-65 years, ruptured saccular aneurysm of anterior circulation with or without lamina terminalis fenestration during clipping, were enrolled through non-probability convenience sampling. Data was collected on all patients concerning postoperative hydrocephalus and the measures to mitigate its adverse effects. SPSS version 21 was utilized for data analysis. RESULTS: The average age of the patients was 46, and 60% were female. In the Lamina terminalis fenestrated group (n=40), the percentage of shunt-dependent hydrocephalus cases following aneurysm clipping was 4% for low Fisher grade and 13% for high Fisher grade. In contrast, in the non-fenestrated group of (n=37) patients, the percentage was 10% for the low Fisher grade and 37% for the high Fisher grade. CONCLUSION: Reducing the likelihood of shunt-dependent hydrocephalus after ruptured aneurysm clipping can be achieved using lamina terminalis fenestration, regardless of fisher grade. It assists in preventing excessive brain retraction, decreasing intracranial pressure, raising brain perfusion, cisternal blood cleansing, and lowering the need for a ventriculoperitoneal shunt in cases of persistent hydrocephalus. Consequently, to reduce the incidence of shunt-dependent hydrocephalus, we recommend routine lamina terminalis fenestration following anterior circulation aneurysm clipping.