Symptomatic hydrocephalus following aneurysmal subarachnoid hemorrhage

Area of Science:

• Neurosurgery
• Neurology
• Vascular Neurology

Background:

• Subarachnoid hemorrhage from intracranial aneurysms can lead to significant complications.
• Hydrocephalus is a known, yet variable, complication following aneurysm rupture.

Purpose of the Study:

• To report the incidence and characteristics of hydrocephalus following intracranial aneurysm surgery.
• To investigate the relationship between hydrocephalus, aneurysm location, and cerebral vasospasm.

Main Methods:

• Retrospective analysis of 500 consecutive patients undergoing surgery for intracranial aneurysms between 1969 and 1980.
• Assessment of hydrocephalus incidence, aneurysm location, and pre-operative subarachnoid hemorrhage episodes.
• Correlation of preoperative hydrocephalus with angiographic evidence of cerebral vasospasm.

Main Results:

• 16.4% of patients developed significant symptomatic hydrocephalus post-aneurysm rupture.
• Hydrocephalus was most frequent following rupture of anterior communicating artery aneurysms.
• Cerebral vasospasm was present in 64% of patients with preoperative hydrocephalus.

Conclusions:

• Symptomatic hydrocephalus is a notable complication after intracranial aneurysm rupture, particularly from anterior communicating artery aneurysms.
• The presence of hydrocephalus may necessitate pre-operative management before addressing the aneurysm.
• Cerebral vasospasm frequently co-exists with hydrocephalus in this patient population.