• Cerebrovascular diseases · Jan 2003

    Independent predictors of late hydrocephalus in patients with aneurysmal subarachnoid hemorrhage--analysis by multivariate logistic regression model.

    • Yutaka Hirashima, Hideo Hamada, Nakamasa Hayashi, Naoya Kuwayama, Hideki Origasa, and Shunro Endo.
    • Department of Neurosurgery, Toyama Medical and Pharmaceutical University, Toyama, Japan. yhira@ms.toyama-mpu.ac.jp
    • Cerebrovasc. Dis. 2003 Jan 1;16(3):205-10.

    ObjectWe determined independent variables contributing to the development of late hydrocephalus after subarachnoid hemorrhage (SAH).MethodsA total of 114 consecutive patients who underwent surgery for aneurysms within 72 h after SAH were studied. Thirty-nine patients underwent ventriculoperitoneal shunt (VPS) placement (14 patients within 30 days and 25 patients more than 30 days after onset). Univariate and multivariate analyses were performed to assess relationships among various variables and shunt placement.ResultsThree variables were found to be independently associated with VPS patients: (1) the rate of SAH clearance; (2) the duration of external cerebrospinal fluid drainage, and (3) presence of neurological deficits 2 weeks after surgery, which indicates brain damage mainly caused by intraoperative manipulation and cerebral vasospasm.ConclusionAs in previous reports, intraoperative clot removal and duration of external CSF drainage were found to be closely related to the incidence of hydrocephalus. Brain damage due to intraoperative manipulation and cerebral vasospasm is seemed to be involved in the occurrence of late hydrocephalus in this study.Copyright 2003 S. Karger AG, Basel

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