title: Predictors and outcomes of shunt-dependent hydrocephalus in patients with aneurysmal sub-arachnoid hemorrhage.
abstract: BACKGROUND
  Hydrocephalus following spontaneous aneurysmal sub-arachnoid hemorrhage (SAH) is often associated with unfavorable outcome. This study aimed to determine the potential risk factors and outcomes of shunt-dependent hydrocephalus in aneurysmal SAH patients but without hydrocephalus upon arrival at the hospital.
  
  
  METHODS
  One hundred and sixty-eight aneurysmal SAH patients were evaluated. Using functional scores, those without hydrocephalus upon arrival at the hospital were compared to those already with hydrocephalus on admission, those who developed it during hospitalization, and those who did not develop it throughout their hospital stay. The Glasgow Coma Score, modified Fisher SAH grade, and World Federation of Neurosurgical Societies grade were determined at the emergency room. Therapeutic outcomes immediately after discharge and 18 months after were assessed using the Glasgow Outcome Score.
  
  
  RESULTS
  Hydrocephalus accounted for 61.9% (104/168) of all episodes, including 82 with initial hydrocephalus on admission and 22 with subsequent hydrocephalus. Both the presence of intra-ventricular hemorrhage on admission and post-operative intra-cerebral hemorrhage were independently associated with shunt-dependent hydrocephalus in patients without hydrocephalus on admission. After a minimum 1.5 years of follow-up, the mean Glasgow outcome score was 3.33 ± 1.40 for patients with shunt-dependent hydrocephalus and 4.21 ± 1.19 for those without.
  
  
  CONCLUSIONS
  The presence of intra-ventricular hemorrhage, lower mean Glasgow Coma Scale score, and higher mean scores of the modified Fisher SAH and World Federation of Neurosurgical grading on admission imply risk of shunt-dependent hydrocephalus in patients without initial hydrocephalus. These patients have worse short- and long-term outcomes and longer hospitalization.
authors: Division of Neurosurgery, Department of Surgery, Yuan's General Hospital, Kaohsiung, Taiwan.
authors: Yi-Min
authors: YM
authors: Wang
authors: Yu-Jun
authors: YJ
authors: Lin
authors: Ming-Jung
authors: MJ
authors: Chuang
authors: Tsung-Han
authors: TH
authors: Lee
authors: Nai-Wen
authors: NW
authors: Tsai
authors: Ben-Chung
authors: BC
authors: Cheng
authors: Wei-Che
authors: WC
authors: Lin
authors: Ben Yu-Jih
authors: BY
authors: Su
authors: Tzu-Ming
authors: TM
authors: Yang
authors: Wen-Neng
authors: WN
authors: Chang
authors: Chih-Cheng
authors: CC
authors: Huang
authors: Chia-Te
authors: CT
authors: Kung
authors: Lian-Hui
authors: LH
authors: Lee
authors: Hung-Chen
authors: HC
authors: Wang
authors: Cheng-Hsien
authors: CH
authors: Lu
mesh_terms: D000328:Adult; D000368:Aged; D002557:Cerebrospinal Fluid Shunts; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D013345:Subarachnoid Hemorrhage / Q000150:complications*; D016896:Treatment Outcome