Independent predictors of late hydrocephalus in patients with aneurysmal subarachnoid hemorrhage--analysis by multivariate logistic regression model.
OBJECTIVE
We determined independent variables contributing to the development of late hydrocephalus after subarachnoid hemorrhage (SAH).


METHODS
A 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.


RESULTS
Three 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.


CONCLUSIONS
As 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.
Hirashima
Yutaka
Y
Department of Neurosurgery, Toyama Medical and Pharmaceutical University, Toyama, Japan. yhira@ms.toyama-mpu.ac.jp
Hamada
Hideo
H
Hayashi
Nakamasa
N
Kuwayama
Naoya
N
Origasa
Hideki
H
Endo
Shunro
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004322:Drainage / Q000009:adverse effects; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications; D011237:Predictive Value of Tests; D012044:Regression Analysis; D012307:Risk Factors; D012720:Severity of Illness Index; D013345:Subarachnoid Hemorrhage / Q000150:complications*; D013997:Time Factors; D020301:Vasospasm, Intracranial / Q000150:complications; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects*