Influence of lamina terminalis fenestration on the occurrence of the shunt-dependent hydrocephalus in anterior communicating artery aneurysmal subarachnoid hemorrhage.
Recently, it was reported that fenestration of the lamina terminalis (LT) may reduce the incidence of shunt-dependent hydrocephalus in aneurysmal subarachnoid hemorrhage (SAH). The authors investigated the efficacy of the LT opening on the incidence of shunt-dependent hydrocephalus in the ruptured anterior communicating artery (ACoA) aneurysms. The data of 71-ruptured ACoA aneurysm patients who underwent aneurysmal clipping in acute stage were reviewed retrospectively. Group I (n=36) included the patients with microsurgical fenestration of LT during surgery, Group II (n=35) consisted of patients in whom fenestration of LT was not feasible. The rate of shunt-dependent hydrocephalus was compared between two groups by logistic regression to control for confounding factors. Ventriculo-peritoneal shunts were performed after aneurysmal obliteration in 18 patients (25.4%). The conversion rates from acute hydrocephalus on admission to chronic hydrocephalus in each group were 29.6% (Group I) and 58.8% (Group II), respectively. However, there was no significant correlation between the microsurgical fenestration and the rate of occurrence of shunt-dependent hydrocephalus (p>0.05). Surgeons should carefully decide the concomitant use of LT fenestration during surgery for the ruptured ACoA aneurysms because of the microsurgical fenestration of LT can play a negative role in reducing the incidence of chronic hydrocephalus.
Kim
Jae Min
JM
Department of Neurosurgery, Hanyang University Guri Hospital, Guri, Korea. kjm2323@hanyang.ac.kr
Jeon
Ji Young
JY
Kim
Jae Hoon
JH
Cheong
Jin Hwan
JH
Bak
Koang Hum
KH
Kim
Choong Hyun
CH
Yi
Hyeong Joong
HJ
Kim
Kwang Myung
KM
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology / Q000517:prevention & control*; D007031:Hypothalamus / Q000601:surgery; D002532:Intracranial Aneurysm / Q000150:complications / Q000601:surgery*; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D012189:Retrospective Studies; D013345:Subarachnoid Hemorrhage / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome; D017287:Ventriculoperitoneal Shunt / Q000379:methods*