Chronic Shunt-dependent Hydrocephalus after Early Surgical and Early Endovascular Treatment of Ruptured Intracranial Aneurysms

Chronic Shunt-dependent Hydrocephalus after Early Surgical and Early Endovascular Treatment of... AbstractOBJECTIVE:The goal of this study was to document the influence of the treatment method (early surgery versus early endovascular treatment) on the development of chronic shunt-dependent hydrocephalus in a series of 242 patients treated within 7 days after aneurysmal subarachnoid hemorrhage (SAH).METHODS:The following parameters were prospectively recorded in a computerized database and retrospectively analyzed for association with chronic shunt-dependent hydrocephalus: 1) Hunt and Hess grade, 2) Fisher computed tomographic grade, 3) incidence of repeat SAH, 4) aneurysm location, and 5) treatment method (early surgery versus early endovascular treatment).RESULTS:Forty of 187 patients (21.4%) who survived the SAH and its neurological and/or medical sequelae underwent definitive shunting for treatment of chronic hydrocephalus. The rate of shunt dependency was positively correlated with a higher Hunt and Hess grade (P < 0.001), a higher Fisher computed tomographic grade (P = 0.003), the occurrence of intraventricular hemorrhage (P < 0.001), repeat SAH (P = 0.003), and aneurysms arising at the anterior communicating artery (P < 0.001).CONCLUSION:The results of the present study indicate that the treatment method used does not affect the risk of the later development of chronic shunt-dependent hydrocephalus (early surgery, 23.2% [29 of 125]; early endovascular treatment, 17.7% [11 of 62]; P = 0.45). http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Neurosurgery Oxford University Press

Chronic Shunt-dependent Hydrocephalus after Early Surgical and Early Endovascular Treatment of Ruptured Intracranial Aneurysms

Chronic Shunt-dependent Hydrocephalus after Early Surgical and Early Endovascular Treatment of Ruptured Intracranial Aneurysms

Chronic Shunt-dependent Hydrocephalus after Early U tf Surgical and Early Endovascular Treatment of Ruptured Intracranial Aneurysms Andreas Gruber, M .D ., Andrea Reinprecht, M .D ., Gerhard Bavinzski, M .D ., Thomas Czech, M .D ., Bernd Richling, M.D. Department of Neurosurgery, University of Vienna Medical School, Vienna, Austria iSC 0! OBJECTIVE: The goal of this study was to document the influence of the treatment method (early surgery versus early endovascular treatment) on the development of chronic shunt-dependent hydrocephalus in a series of 242 patients treated within 7 days after aneurysmal subarachnoid hemorrhage (SAH). METHODS: The following parameters were prospectively recorded in a computerized database and retrospectively analyzed for association with chronic shunt-dependent hydrocephalus: 1) Hunt and Hess grade, 2) Fisher I computed tomographic grade, 3) incidence of repeat SAH, 4) aneurysm location, and 5) treatment method (early surgery versus early endovascular treatment). RESULTS: Forty of 187 patients (2 1 .4 % ) who survived the SAH and its neurological and/or medical sequelae underwent definitive shunting for treatment of chronic hydrocephalus. The rate of shunt dependency was positively correlated with a higher Hunt and Hess grade (P < 0.001), a higher Fisher computed tomographic grade (P = 0.003), the occurrence of intraventricular hemorrhage (P < 0.001), repeat SAH (P = 0.003), and aneurysms arising at the anterior communicating artery (P < 0.001). C O N C L U S IO N : The results of the present study indicate that the treatment method used does not affect the risk of the later development of chronic shunt-dependent hydrocephalus (early surgery, 2 3 .2 % [29 of 125]; early endovascular treatment, 1 7 .7 % [11 of 62]; P = 0.45). (Neurosurgery 4 4 :5 0 3 -5 1 2 , 1999) Keywords: Endovascular treatment, Hydrocephalus, Intracranial aneurysm, Microsurgery, Shunt, Subarachnoid hemorrhage chronic hydrocephalus rate with the use of...
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Publisher
Congress of Neurological Surgeons
Copyright
© Published by Oxford University Press.
ISSN
0148-396X
eISSN
1524-4040
D.O.I.
10.1097/00006123-199903000-00039
Publisher site
See Article on Publisher Site

Abstract

AbstractOBJECTIVE:The goal of this study was to document the influence of the treatment method (early surgery versus early endovascular treatment) on the development of chronic shunt-dependent hydrocephalus in a series of 242 patients treated within 7 days after aneurysmal subarachnoid hemorrhage (SAH).METHODS:The following parameters were prospectively recorded in a computerized database and retrospectively analyzed for association with chronic shunt-dependent hydrocephalus: 1) Hunt and Hess grade, 2) Fisher computed tomographic grade, 3) incidence of repeat SAH, 4) aneurysm location, and 5) treatment method (early surgery versus early endovascular treatment).RESULTS:Forty of 187 patients (21.4%) who survived the SAH and its neurological and/or medical sequelae underwent definitive shunting for treatment of chronic hydrocephalus. The rate of shunt dependency was positively correlated with a higher Hunt and Hess grade (P < 0.001), a higher Fisher computed tomographic grade (P = 0.003), the occurrence of intraventricular hemorrhage (P < 0.001), repeat SAH (P = 0.003), and aneurysms arising at the anterior communicating artery (P < 0.001).CONCLUSION:The results of the present study indicate that the treatment method used does not affect the risk of the later development of chronic shunt-dependent hydrocephalus (early surgery, 23.2% [29 of 125]; early endovascular treatment, 17.7% [11 of 62]; P = 0.45).

Journal

NeurosurgeryOxford University Press

Published: Mar 1, 1999

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