Influences of Different Treatment on Shunt dependent Hydrocephalus after Aneurysmal Subarachnoid Hemorrhage

Guo Fang; Li Zhongzhen

doi:10.11850/j.issn.1009-122X.2016.03.002

Abstract：Objective To compare the influences of microsurgical clipping and endovascular embolization treatment on shunt-dependent hydrocephalus after aneurysmal subarachnoid hemorrhage (aSAH), and explore the high risk factors for shunt-dependent hydrocephalus. Methods Clinical data of 266 patients with aSAH were analyzed retrospectively, and the patients were divided into clipping group (n=164 ) and embolization group ( n = 102 ) according to the different surgical methods . Then , 37 patients who needed to perform ventriculoperitoneal shun served as shunt group, and the other patients as non-shunt group. The clinical data in two groups were analyzed statistically. Results No significant difference in the incidence of shunt-dependent hydrocephalus was observed between clipping group and embolization group ( P > 0 . 05 ) . There were significant differences in age , Hunt-Hess grade , Fisher grade and intraventricular hemorrhage between shunt group and non-shunt group (P<0.05), while there were no significant differences in the incidence of acute hydrocephalus and location of aneurysm (P>0.05). With logistic regression analysis, the independent risk factors for shunt-dependent hydrocephalus after aSAH were as follows: equal or older than 65 years, Hunt-Hess grade Ⅳ or Ⅴ, Fisher grade Ⅲ or Ⅳ and intraventricular hemorrhage. Conclusions There is no significant difference in the incidence of shunt-dependent hydrocephalus between microsurgical clipping and endovascular embolization in patients with aSAH. The patients with advanced age, poor initial neurological status and intraventricular hemorrhage are more easier to occur shunt-dependent hydrocephalus, to which more attention needs to be given.