Chronic hydrocephalus after neurosurgical and endovascular treatment of ruptured intracranial aneurysms.
BACKGROUND
Chronic hydrocephalus is a common sequela of subarachnoid hemorrhage (SAH). The technical procedure used to treat intracranial aneurysms, whether neurosurgical clipping or endovascular coiling, may lead to differences in the incidence of chronic posthemorrhagic hydrocephalus.


OBJECTIVE
To compare the effects of early neurosurgical and early endovascular treatment on the development of chronic hydrocephalus in patients with SAH.


METHODS
A retrospective study included 102 clipped and 107 coiled patients with aneurysmal SAH. Clinical condition at admission and shunt dependence were verified from patient data records. The initial and follow-up computed tomography (CT) images were reviewed, and the amount and distribution of blood and the occurrence of hydrocephalus were registered. The values of the cella media index and the width of the third ventricle were calculated. Statistical analysis of the data was performed.


RESULTS
No statistically significant differences in the incidence of chronic hydrocephalus or the need for shunting emerged between the treatment groups. After clipping 35% and after coiling 39% of the patients developed chronic hydrocephalus. Twenty-nine percent of the clipped and 31% of the coiled patients underwent a shunt operation.


CONCLUSIONS
The treatment method used for acutely ruptured intracranial aneurysms, i.e., neurosurgical clipping or endovascular coiling, has no statistically significant effect on the development of chronic hydrocephalus.
Department of Diagnostic and Interventional Radiology, Oulu University Hospital, Oulu, Finland.
P
P
Jartti
A
A
Karttunen
J-M
JM
Isokangas
A
A
Jartti
T
T
Koskelainen
O
O
Tervonen
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000150:complications / Q000601:surgery / Q000628:therapy*; D001921:Brain / Q000000981:diagnostic imaging; D002557:Cerebrospinal Fluid Shunts; D002908:Chronic Disease; D004621:Embolization, Therapeutic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006849:Hydrocephalus / Q000175:diagnosis / Q000209:etiology*; D002532:Intracranial Aneurysm / Q000150:complications / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology*; D012189:Retrospective Studies; D013345:Subarachnoid Hemorrhage / Q000150:complications*; D014057:Tomography, X-Ray Computed