Summary
The incidence of chronic hydrocephalus was analysed in a series of 204 patients with aneurysmal subarachnoid haemorrhage (SAH). Its development was significantly related to the quantity of subarachnoid blood, but even more to the location of the haemorrhage and to the aneurysm site. Hydrocephalus was more frequent in patients under poor initial condition. Whereas intracerebral haemorrhage did not increase the risk of chronic cerebrospinal fluid (CSF) resorption disturbances, patients with intraventricular haemorrhage or voluminous haemorrhage in the basal cisterns have a significantly higher risk of such a complication. In this series 30 (15%) patients developed chronic hydrocephalus and required shunting. Surprisingly, in our series a shunt wasnever needed in patients with aneurysms of the middle cerebral artery (MCA). SAH from an aneurysm of the internal carotid artery (ICA) also never caused a shunt-dependent hydrocephalus except in cases with accompanying intraventricular haemorrhage. The percentage of chronic hydrocephalus was relatively high (19%) in patients with anterior communicating artery (ACoA) aneurysms but definitely highest in patients with an aneurysm of the vertebrobasilar (VB) system (53%).
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References
Auer LM, Mokry M (1990) Disturbed cerebrospinal fluid circulation after subarachnoid hemorrhage and acute aneurysm surgery. Neurosurgery 26: 804–809
Dolenc VV (1985) The value of CSF drainage during aneurysm surgery and prevention of the development of hydrocephalus. In: Auer LM (ed) Timing of aneurysm surgery, de Gruyter, Berlin, pp 343–347
Gilsbach JM, Harders AG, Eggert HR, Hornyak ME (1988) Early aneurysm surgery: a seven year clinical practice report. Acta Neurochir (Wien) 90: 91–102
Graff-Radford NR, Torner JC, Adams HP, Kassell NF (1989) Factors associated with hydrocephalus after subarachnoid hemorrhage. Arch Neurol 46: 744–752
Hornyak M, Gilsbach JM, Harders AG (1991) Clinical significance of computed tomography in early aneurysm surgery. Neurochirurgia 334: 135–140
Hunt WE, Hess RM (1967) Surgical risk as related to time of intervention in the repair of intracranial aneurysms. J Neurosurg 28: 14–20
Hunt WE, Kassell N, Pertuiset B, Sano K, Teasdale G, de Villier JC, Drake CG (1988) Report of the World Federation of Neurological Surgeons Committee on a Universal Subarachnoid Hemorrhage Grading Scale. J Neurosurg 68: 985–986
Kassell NF, Torner JC, Haley EC, Jane JA, Adams HP, Kongable GL and participants (1990) The internal cooperative study on the timing of aneurysm surgery. J Neurosurg 73: 18–36
Kibler RF, Couch RSC, Crompton MR (1961) Hydrocephalus in the adult following spontaneous subarachnoid hemorrhage. Brain 84: 45–61
Noterman J, D'Haens J, Brotchi J (1986) Bilan de trois ans de traitement chirurgical des anevrysmes intracraniens. A propos de 100 anevrysmes operes. Acta Neurol Belg 86: 243–259
Papo I, Bodosi M, Merei TF, Luongo A (1984) L'hydrocephalie apres hemorragie sous-arachnoidienne. Neurochirurgie 30: 159–164
Plangger C, Twerdy K, Mohsenipour I, Grunert V, Pallua A (1987) Hydrocephalus nach spontaner Subarachnoidalblutung. Neurochirurgia 30: 154–157
Rajshekhar V, Harbaugh RE (1992) Results of routine ventriculostomy with external ventricular drainage for acute hydrocephalus following subarachnoid haemorrhage. Acta Neurochir (Wien) 115: 8–14
Säveland H, Hillman J, Brandt L, Edner G, Jakobsson KE, Algers G (1992) Overall outcome in aneurysmal subarachnoid hemorrhage. A prospective study from neurosurgical units in Sweden during a 1-year period. J Neurosurg 76: 729–734
Sano H, Kanno T, Katada K, Ishiyama N, Katou Y (1985) Timing of operation after subarachnoid hemorrhage since the introduction of CT. In: Auer LM (ed) Timing of aneurysm surgery. Gruyter, Berlin, pp 153–163
Seiler RW, Reulen HJ, Huber, Grolimund P, Ebeling U, Steiger HJ (1988) Outcome of aneurysmal subarachnoid hemorrhage in a hospital population: a prospective study including early operation, intravenous nimodipine and transcranial Doppler ultrasound. Neurosurgery 23: 598–604
Shiino A, Suzuki F, Nakazawa T, Matsuda M, Handa J (1988) Hydrocephalus after aneurysmal subarachnoid hemorrhage. No-Shinkei-Geka 16: 493–497
Shulman K, Martin BF, Popoff N, Rausohoff J (1963) Recog nition and treatment of hydrocephalus following spontaneous subarachnoid hemorrhage. J Neurosurg 20: 1040–1047
Spallone A, Gagliardi FM (1983) Hydrocephalus following aneurysmal SAH. Zbl Neurochir 44: 141–150
Sundt TM, Kobayashi S, Fode NC, Whisnant JP (1982) Results and complications of surgical management of 809 intracranial aneurysms in 722 cases. J Neurosurg 56: 753–765
Vassilouthis J, Richardson AE (1979) Ventricular dilatation and communicating hydrocephalus following spontaneous subarachnoid hemorrhage. J Neurosurg 51: 341–351
Yasui N, Ito Z, Ohta H, Suzuki A (1982) Surgical problems and pathophysiology in severe cases with ruptured aneurysm in the acute stage. Acta Neurochir (Wien) 63: 163–174
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Pietilä, T.A., Heimberger, K.C., Palleske, H. et al. Influence of aneurysm location on the development of chronic hydrocephalus following SAH. Acta neurochir 137, 70–73 (1995). https://doi.org/10.1007/BF02188784
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DOI: https://doi.org/10.1007/BF02188784