ReviewActa neurologica Belgica2025
Ventricular lavage versus conservative treatment in cerebral ventriculitis outcomes: a systematic review.
Review in Acta neurologica Belgica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
10 authors.
Funding
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Abstract
backgroundCerebral ventriculitis is a severe intraventricular infection with mortality rates of 30-71% despite standard treatment with antibiotics and external ventricular drainage (EVD). Ventricular lavage (VL) has emerged as an adjunctive therapy, but its comparative effectiveness remains uncertain. We aimed to systematically compare outcomes between VL and conservative management in cerebral ventriculitis.
methodsWe conducted a PRISMA-compliant systematic review of PubMed/MEDLINE, Cochrane Library, and ClinicalTrials.gov through January 2025, including 10 studies (n = 322 patients).
resultsVL demonstrated significantly better outcomes across all measured parameters. Mortality was lower with VL (0-25%) versus conservative treatment (23.5-52.9%; p < 0.05 in comparative studies). Hospital stays were 22-50% shorter with VL (20.5-59 vs. 39.7-81 days). Neurological outcomes favored VL, with 66.7-68.8% achieving mRS ≤ 3 versus 23.5-25% in controls. CSF parameters normalized faster with VL (leukocytes: 4 vs. 12 days; protein: 12.9 vs. 27.2 days). VL reduced shunt dependency (56-91% vs. 100%) and infections (2 vs. 7 cases).
conclusionsVentricular lavage significantly improves survival, accelerates recovery, and reduces complications compared to conservative management. While current evidence is limited by study heterogeneity, the consistent positive outcomes support consideration of VL for cerebral ventriculitis. Larger randomized trials are needed to optimize protocols and confirm these benefits.
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