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Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
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Predisposing factors related to shunt-dependent chronic hydrocephalus after aneurysmal subarachnoid hemorrhage

Jae-Hyun Kwon1, Soon-Ki Sung, Young-Jin Song

  • 1Department of Neurosurgery, College of Medicine, Dong-A University, Busan, Korea.

Journal of Korean Neurosurgical Society
|December 20, 2008
PubMed

Insights

Older age, poor admission grade, intraventricular hemorrhage, and meningitis predict shunt-dependent hydrocephalus after aneurysmal subarachnoid hemorrhage (SAH). Identifying these factors aids neurosurgeons in improving patient outcomes.

Area of Science:

  • Neurosurgery
  • Neurology
  • Radiology

Background:

  • Hydrocephalus is a frequent complication of aneurysmal subarachnoid hemorrhage (SAH).
  • Patients developing hydrocephalus post-SAH generally experience poorer prognoses.
  • Identifying predictive factors for shunt-dependent hydrocephalus is crucial for patient management.

Purpose of the Study:

  • To identify factors predicting the development of shunt-dependent chronic hydrocephalus in patients with aneurysmal SAH.
  • To determine predictors for patients requiring permanent cerebrospinal fluid diversion after SAH.

Main Methods:

  • Retrospective study of 734 patients with aneurysmal SAH treated surgically (1990-2006).
  • Hydrocephalus categorized into acute (0-3 days), subacute (4-13 days), and chronic (≥14 days) post-SAH.
  • CT scan criteria for hydrocephalus included enlarged temporal horns or frontal horn to biparietal diameter ratio >30%.

Main Results:

  • 8.9% (66/734) of patients required shunting for chronic hydrocephalus.
  • Significant predictors for shunt-dependent hydrocephalus included: increased age, poor Hunt and Hess grade, intraventricular hemorrhage, Fisher grade III/IV, radiological hydrocephalus at admission, and post-surgery meningitis.
  • Intracerebral hemorrhage, multiple aneurysms, vasospasm, gender, and aneurysm location in the posterior circulation did not significantly influence the development of shunt-dependent hydrocephalus.

Conclusions:

  • The etiology of hydrocephalus following aneurysmal SAH is multifactorial.
  • Understanding predisposing factors for shunt-dependent chronic hydrocephalus can guide neurosurgeons toward improved treatment strategies and outcomes.
Abstract

Keywords:
Chronic hydrocephalusRelated factorSubarachnoid hemorrhageVentriculoperitoneal shunt

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