Relationship between shunt-dependent hydrocephalus after subarachnoid haemorrhage and duration of cerebrospinal fluid drainage.
Subarachnoid haemorrhage (SAH) patients in Fisher group 3 have a high risk of vasospasm and chronic hydrocephalus. We have provided cisternal irrigation combined with a head-shaking method for preventing vasospasm in SAH patients. We investigated 76 SAH patients in Fisher group 3 who received cisternal irrigation with head-shaking to evaluate the relationship between the occurrence of hydrocephalus and various clinical factors, including duration of cerebrospinal fluid (CSF) drainage. Chronic hydrocephalus occurred in 25 patients (33%). The occurrence of hydrocephalus was associated with longer duration of CSF drainage (median, 13 days versus 9 days). By logistic regression analysis using significant factors, including age, preoperative neurological grade and Glasgow Outcome Scale, only the duration of drainage was independently associated with the occurrence of hydrocephalus (Odds ratio = 1.18 per day; 95% confidence interval, 1.02- 1.36). These results indicate that long duration of CSF drainage for preventing vasospasm may increase the occurrence of hydrocephalus.
Ohwaki
K
K
Department of Hygiene and Public Health, Teikyo University School of Medicine, Itabashi, Tokyo, Japan. ns-waki@med.teikyo-u.ac.jp
Yano
E
E
Nakagomi
T
T
Tamura
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002555:Cerebrospinal Fluid; D002946:Cisterna Magna; D004322:Drainage / Q000009:adverse effects*; D005260:Female; D019416:Head Movements; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology* / Q000601:surgery; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013345:Subarachnoid Hemorrhage / Q000150:complications* / Q000628:therapy; D007507:Therapeutic Irrigation; D013997:Time Factors; D020301:Vasospasm, Intracranial / Q000517:prevention & control; D017287:Ventriculoperitoneal Shunt