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KMID : 1159220060010010032
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Journal of Korean Society of Intravascular Neurosurgery
2006 Volume.1 No. 1 p.32 ~ p.37
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Clinical Analysis of Factors Related to Shunt-Dependent Hydrocephalus after Early Surgery and Early Endovascular Treatment of Aneurysmal Subarachnoid Hemorrage
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Choi Gyeong-Mi
Chang In-Bok
Kim Young-Woo
Rim Dae-Cheol
Song Joon-Ho
Ahn Sung-Ki
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Abstract
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Objective：The purpose of this study was to analyse factors related to shunt-dependent hydrocephalus of the aneurysmal subarachnoid hemorrhage treated with early clipping and endovascular surgery.
Methods：A series of one hundred ninety six consecutive patients with aneurysmal subarachnoid hemorrhage were treated from June 2001 through June 2006. One hundred sixteen patients underwent early surgical clipping, eighty patients were performed early endovascular coil embolization. The following factor were retrospectively analysed contributing to shunt-dependent hydrocephlus: 1) age, 2) sex, 3) Hunt and Hess grade, 4) Fisher computed tomographic grade, 5) aneurysm location, 6) external ventricular drainage (EVD), 7) hypertension, 8) smoking, 9) hydrocephalus at admission and 10) clinical outcome.
Result：Overall, twenty six patients of one hundred ninety six patients underwent ventiriculo-peritoneal shunt for treating shunt-dependent hydrocephlus (13.3%). The rate of shunt dependency was 14.7% (17 of 116) in the surgical treatment group and 11.3% (9 of 80) in the coil embolization group. In our investigation, there were factors associated with shunt-dependent hydrocephlus: 1) old age, 2) high Hunt and Hess grade, 3) high Fisher grade, 4) early extraventricular drainage (EVD), 5) hydrocephlus at admission and 6) low Glasgow outcome scale (GOS).
Conclusion：The result of this study suggests that the modality of aneurysm treatment does not significantly affect the incidence of shunt-dependent hydrocephalus. Old age, high Hunt and Hess grade, high Fisher grade, early EVD, hydrocephalus at admission and low GOS are related to the development of shunt-dependent hydrocephalus.
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KEYWORD
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Shunt-dependent hydrocephalus, Aneurysm, Subarachnoid hemorrhage, Coil embolization
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