title: Effect of cisternal drainage on the shunt dependency following aneurysmal subarachnoid hemorrhage.
abstract: OBJECTIVE
  Shunt-dependent chronic hydrocephalus (SDCH) is known to be a major complication associated with aneurysmal subarachnoid hemorrhage (aSAH). Old age is known to be one of numerous factors related to the development of SDCH. This study investigated whether postoperative cisternal drainage affects the incidence of SDCH and clinical outcome in elderly patients with aSAH.
  
  
  METHODS
  Fifty-nine patients participated in this study. All patients underwent aneurysmal clipping with cisternal cerebrospinal fluid (CSF) drainage. Clinical variables relevant to the study included age, sex, location of ruptured aneurysm, CT finding and clinical state on admission, clinical outcome, and CSF drainage. We first divided patients into two groups according to age (<70 years of age and ≥70 years of age) and compared the two groups. Secondly, we analyzed variables to find factors associated with SDCH in both groups (<70 years of age and ≥70 years of age).
  
  
  RESULTS
  Of 59 patients, SDCH was observed in 20 patients (33.9 %), who underwent shunt placement for treatment of hydrocephalus. Forty seven percent of cases of acute hydrocephalus developed SDCH. In the elderly group (≥70 years of age), the duration and amount of CSF drainage did not affect the development of chronic hydrocephalus.
  
  
  CONCLUSIONS
  In elderly patients, although the incidence of SDCH was significantly higher, clinical outcome was acceptable. The duration and the amount of cisternal drainage did not seem to be related to subsequent development of chronic hydrocephalus within elderly patients aged 70 or older.
authors: Department of Neurology, College of Medicine, Kangwon National University, Chuncheon, Korea.
authors: Sung Hun
authors: SH
authors: Kim
authors: Pil-Wook
authors: PW
authors: Chung
authors: Yu Sam
authors: YS
authors: Won
authors: Young Joon
authors: YJ
authors: Kwon
authors: Hyun Chul
authors: HC
authors: Shin
authors: Chun Sik
authors: CS
authors: Choi
keywords: Acute hydrocephalus; Aneurysmal subarachnoid hemorrhage; Intraventricular hemorrhage; Old age; Shunt-dependent chronic hydrocephalus