| Predisposing factors related to shunt-dependent chronic hydrocephalus after aneurysmal subarachnoid hemorrhage. | |
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MedLine Citation:
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PMID: 19096639 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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OBJECTIVE: Hydrocephalus is a common sequelae of aneurysmal subarachnoid hemorrhage (SAH) and patients who develop hydrocephalus after SAH typically have a worse prognosis than those who do not. This study was designed to identify factors predictive of shunt-dependent chronic hydrocephalus among patients with aneurysmal SAH, and patients who require permanent cerebrospinal fluid diversion. METHODS: Seven-hundred-and-thirty-four patients with aneurysmal SAH who were treated surgically between 1990 and 2006 were retrospectively studied. Three stages of hydrocephalus have been categorized in this paper, i.e., acute (0-3 days after SAH), subacute (4-13 days after SAH), chronic (>/=14 days after SAH). Criteria indicating the occurrence of hydrocephalus were the presence of significantly enlarged temporal horns or ratio of frontal horn to maximal biparietal diameter more than 30% in computerized tomography. RESULTS: Overall, 66 of the 734 patients (8.9%) underwent shunting procedures for the treatment of chronic hydrocephalus. Statistically significant associations among the following factors and shunt-dependent chronic hydrocephalus were observed. (1) Increased age (p < 0.05), (2) poor Hunt and Hess grade at admission (p < 0.05), (3) intraventricular hemorrhage (p < 0.05), (4) Fisher grade III, IV at admission (p < 0.05), (5) radiological hydrocephalus at admission (p < 0.05), and (6) post surgery meningitis (p < 0.05) did affect development of chronic hydrocephalus. However the presence of intracerebral hemorrhage, multiple aneurysms, vasospasm, and gender did not influence on the development of shunt-dependent chronic hydrocephalus. In addition, the location of the ruptured aneurysms in posterior cerebral circulation did not correlate with the development of shunt-dependent chronic hydrocephalus. CONCLUSION: Hydrocephalus after aneurysmal SAH seems to have a multifactorial etiology. Understanding predisposing factors related to the shunt-dependent chronic hydrocephalus may help to guide neurosurgeons for better treatment outcomes. |
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Authors:
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Jae-Hyun Kwon; Soon-Ki Sung; Young-Jin Song; Hyu-Jin Choi; Jae-Taeck Huh; Hyung-Dong Kim |
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Publication Detail:
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Type: Journal Article Date: 2008-04-20 |
Journal Detail:
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Title: Journal of Korean Neurosurgical Society Volume: 43 ISSN: 2005-3711 ISO Abbreviation: J Korean Neurosurg Soc Publication Date: 2008 Apr |
Date Detail:
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Created Date: 2008-12-19 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101467054 Medline TA: J Korean Neurosurg Soc Country: Korea (South) |
Other Details:
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Languages: eng Pagination: 177-81 Citation Subset: - |
Affiliation:
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Department of Neurosurgery, College of Medicine, Dong-A University, Busan, Korea. |
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