| Factors related to hydrocephalus after aneurysmal subarachnoid hemorrhage. | |
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MedLine Citation:
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PMID: 12657171 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Zeena Dorai; Linda S Hynan; Thomas A Kopitnik; Duke Samson |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Neurosurgery Volume: 52 ISSN: 0148-396X ISO Abbreviation: Neurosurgery Publication Date: 2003 Apr |
Date Detail:
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Created Date: 2003-03-26 Completed Date: 2003-07-03 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 7802914 Medline TA: Neurosurgery Country: United States |
Other Details:
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Languages: eng Pagination: 763-9; discussion 769-71 Citation Subset: IM |
Affiliation:
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Department of Neurosurgery, University of Texas at Southwestern Medical Center, Dallas 75390-8855, USA. zdorai@excite.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Aneurysm, Ruptured / mortality, radiography, surgery* Cerebral Angiography Cerebrospinal Fluid Shunts Embolization, Therapeutic Female Follow-Up Studies Humans Hydrocephalus / etiology*, mortality, radiography, surgery Intracranial Aneurysm / mortality, radiography, surgery* Male 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 Ventriculostomy |
| Comments/Corrections | |
Comment In:
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Neurosurgery. 2004 Apr;54(4):1031
[PMID:
15088618
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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