Effects of Cerebrospinal Fluid Drainage on Cerebral Hemodynamics

This intervention involves temporary cerebrospinal fluid (CSF) drainage via lumbar drain in acute ischemic stroke patients with MRI-confirmed hemodynamic failure. The lumbar drain is inserted at the bedside or in a procedural suite under sterile conditions and connected to a pressure-regulated, closed drainage system. Drainage is continuous for 48-72 hours, with volume and pressure carefully monitored. This intervention is distinct in targeting stroke patients without hydrocephalus, using CSF drainage as a novel method to improve cerebral perfusion and vascular reserve. The effect is evaluated with serial BOLD-CVR MRI performed before and after the drainage period, making this one of the first interventional stroke studies to use functional MRI as a physiological endpoint.