Rehabilitation of patients with chronic normal-pressure hydrocephalus after aneurysmal subarachnoid hemorrhage benefits from ventriculoperitoneal shunt.
This study compares the effect and rehabilitation prognosis of 6-month combined ventriculoperitoneal shunt (VPS) versus rehabilitation training alone in chronic normal-pressure hydrocephalus patients.


METHODS
After suffering from aneurysmal subarachnoid hemorrhage, 39 subjects were diagnosed with chronic normal-pressure hydrocephalus because of clinical deterioration or nonimprovement of gait ataxia, cognitive disturbance, and/or urinary incontinence during rehabilitation. Twenty-four subjects underwent ventriculoperitoneal shunt (VPS) placement, while 15 subjects did not undergo the procedure.


RESULTS
Statistically significant increases in the Barthel Index (BI) were observed between the treatment and control groups 1 month (p < .05) and 6 months (p < .01) after VPS placement. Similar changes also were observed for the Mini-Mental State Examination (MMSE) at the 1-month (p < .01) and 6-month follow-up visits (p < .01). Significant differences in the change in MMSE and BI at admission, before VPS placement, and at 1 month and 6 months after VPS placement in the treatment group were demonstrated (p < .01).


CONCLUSIONS
Chronic normal-pressure hydrocephalus after aneurysmal subarachnoid hemorrhage is an important issue to which clinicians should pay attention. It negatively influences the functional and behavioral outcome of rehabilitation but can be treated.
Chen
Zhen
Z
Department of Rehabilitation, and Department of Neurosugery, Xuanwu Hospital of Capital Medical University, Beijing, China.
Song
Weiqun
W
Du
Jubao
J
Li
Guangqing
G
Yang
Yanhui
Y
Ling
Feng
F
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006850:Hydrocephalus, Normal Pressure / Q000000981:diagnostic imaging / Q000209:etiology* / Q000534:rehabilitation*; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013345:Subarachnoid Hemorrhage / Q000601:surgery*; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects*