Document Detail

Factors related to hydrocephalus after aneurysmal subarachnoid hemorrhage.
MedLine Citation:
PMID:  12657171     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The purpose of this study was to identify factors predictive of shunt-dependent hydrocephalus among patients with aneurysmal subarachnoid hemorrhage. The data can be used to predict which patients in this group have a high probability of requiring permanent cerebrospinal fluid diversion. METHODS: Seven hundred eighteen patients with aneurysmal subarachnoid hemorrhage who were treated between 1990 and 1999 were retrospectively studied, to identify factors contributing to shunt-dependent hydrocephalus. With these data, a stepwise logistic regression procedure was used to determine the effect of each variable on the development of hydrocephalus and to create a scoring system. RESULTS: Overall, 152 of the 718 patients (21.2%) underwent shunting procedures for treatment of hydrocephalus. Four hundred seventy-nine of the patients (66.7%) were female. Of the factors investigated, the following were associated with shunt-dependent hydrocephalus, as determined with a variety of statistical methods: 1) increasing age (P < 0.001), 2) female sex (P = 0.015), 3) poor admission Hunt and Hess grade (P < 0.001), 4) thick subarachnoid hemorrhage on admission computed tomographic scans (P < 0.001), 5) intraventricular hemorrhage (P < 0.001), 6) radiological hydrocephalus at the time of admission (P < 0.001), 7) distal posterior circulation location of the ruptured aneurysm (P = 0.046), 8) clinical vasospasm (P < 0.001), and 9) endovascular treatment (P = 0.013). The presence of intracerebral hematomas, giant aneurysms, or multiple aneurysms did not influence the development of shunt-dependent hydrocephalus. CONCLUSION: The results of this study can help identify patients with a high risk of developing shunt-dependent hydrocephalus. This may help neurosurgeons expedite treatment, may decrease the cost and length of hospital stays, and may result in improved outcomes.
Zeena Dorai; Linda S Hynan; Thomas A Kopitnik; Duke Samson
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Neurosurgery     Volume:  52     ISSN:  0148-396X     ISO Abbreviation:  Neurosurgery     Publication Date:  2003 Apr 
Date Detail:
Created Date:  2003-03-26     Completed Date:  2003-07-03     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  763-9; discussion 769-71     Citation Subset:  IM    
Department of Neurosurgery, University of Texas at Southwestern Medical Center, Dallas 75390-8855, USA.
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MeSH Terms
Aged, 80 and over
Aneurysm, Ruptured / mortality,  radiography,  surgery*
Cerebral Angiography
Cerebrospinal Fluid Shunts
Embolization, Therapeutic
Follow-Up Studies
Hydrocephalus / etiology*,  mortality,  radiography,  surgery
Intracranial Aneurysm / mortality,  radiography,  surgery*
Middle Aged
Postoperative Complications / etiology*,  mortality,  radiography,  surgery
Retrospective Studies
Risk Factors
Subarachnoid Hemorrhage / mortality,  radiography,  surgery*
Survival Rate
Tomography, X-Ray Computed
Vasospasm, Intracranial / etiology,  mortality,  radiography,  surgery
Comment In:
Neurosurgery. 2004 Apr;54(4):1031   [PMID:  15088618 ]

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