[Hydrocephalus and vasospasm after subarachnoid hemorrhage from ruptured intracranial aneurysms]

The relationship of the amount of subarachnoid blood to the incidence of acute hydrocephalus, delayed vasospasm, and chronic hydrocephalus was investigated in 47 patients with subarachnoid hemorrhage from ruptured intracranial aneurysms. Acute hydrocephalus, delayed vasospasm, and chronic hydrocephalus occurred in 29%, 7%, and 14% of Fisher Group 1 & 2 patients respectively, in contrast, 70%, 64%, and 58% of Fisher Group 3 patients (p less than 0.01). Thirty six percents of all patients had both acute hydrocephalus and vasospasm; Thirty two percents had neither. Twenty one percents had acute hydrocephalus, but no spasm; Eleven percents had spasm, but no acute hydrocephalus. Acute hydrocephalus and vasospasm were significantly associated (p less than 0.05). Most of patients with chronic hydrocephalus showed severe subarachnoid hemorrhage on initial CT scan, followed acute hydrocephalus, and highly associated with vasospasm. These sequelae of SAH are closely linked, mainly by the presence of subarachnoid clot, but there may be some direct causal relationship between them.