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Long-term Outcomes and Risk Factors Related to Hydrocephalus After Intracerebral Hemorrhage

Rong Hu1, Chao Zhang2, Jiesheng Xia2

  • 1Department of Neurosurgery and Key Laboratory of Neurotrauma, Southwest Hospital, Third Military Medical University (Army Medical University), No. 30, Gaotanyan, Shapingba District, Chongqing, 400038, China. huchrong@tmmu.edu.cn.

Translational Stroke Research
|June 10, 2020
PubMed

Insights

Hydrocephalus following intracerebral hemorrhage (ICH) is common, with risk factors including infratentorial location and ventricular extension. Patients with ICH-related hydrocephalus face significantly higher mortality rates.

Area of Science:

  • Neurology
  • Neurosurgery
  • Critical Care Medicine

Background:

  • Hydrocephalus is a frequent complication of intracerebral hemorrhage (ICH).
  • Long-term outcomes and predictive factors for hydrocephalus post-ICH remain understudied.
  • Understanding these factors is crucial for managing ICH patients.

Purpose of the Study:

  • To determine the long-term outcomes of hydrocephalus after ICH.
  • To analyze the risk factors predicting the development of hydrocephalus following ICH.
  • To assess the impact of hydrocephalus on mortality in ICH survivors.

Main Methods:

  • Retrospective review of 1342 patients with ICH from 2010-2016.
  • Logistic regression analysis to identify risk factors for hydrocephalus development at different time points (≤3 days, 4-13 days, ≥14 days).
  • Long-term follow-up for survival status and cause of death (median 5.2 years).

Main Results:

  • 120 patients (8.9%) developed hydrocephalus after ICH.
  • Early risk factors (≤3 days) included infratentorial hemorrhage, ventricular extension, ICH volume, and hematoma expansion.
  • Ventricular extension was an independent predictor for hydrocephalus at 4-13 days and ≥14 days, along with decompressive craniotomy and infection for later onset.
  • All-cause mortality was significantly higher in patients with hydrocephalus (HR 3.22).
  • Mortality was 49.2% in hydrocephalus patients, with infection being a leading cause of death (64.4%).

Conclusions:

  • Hydrocephalus is a common complication of ICH, often presenting early.
  • Specific radiological and clinical factors predict hydrocephalus development post-ICH.
  • Hydrocephalus significantly increases mortality risk in ICH patients, highlighting the need for timely diagnosis and management.

Keywords:
HydrocephalusIntracerebral hemorrhageLong-term outcomeRisk factors

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