title: Hydrocephalus onset after microsurgical or endovascular treatment for acute subarachnoid hemorrhage. Retrospective italian multicenter study.
abstract: BACKGROUND
  Chronic shunt-dependent hydrocephalus is a complication of aneurysmal subarachnoid hemorrhage (aSAH). Its incidence and risk factors have been described while the hydrocephalus onset in terms of days after treatment (microsurgical or endovascular) has not been yet analyzed.
  
  
  METHODS
  45 patients, treated for aSAH in 4 Italian Neurosurgical Departments, were retrospectively analyzed. It was calculated the time that elapses between treatment and hydrocephalus onset in 36 patients.
  
  
  RESULTS
  Of the 45 shunted patients, 15 (33.3%) were included in the microsurgical group (group A) and 30 (66.6%) were in the endovascular one (group B). There was no difference of the hydrocephalus onset between the two groups (24,1 days, group A vs. 27,7 days, group B). The presence of intracerebral hematoma (ICH) caused a delay in the hydrocephalus onset after endovascular treatment in terms of 11,5 days compared to microsurgical group as well the absence of vasospasm determined a delay of 13,7 days (not statistically significant).
  
  
  CONCLUSIONS
  No difference in terms of hydrocephalus onset after microsurgical or endovascular treatment has been demonstrated. Only the presence of ICH or the absence of vasospasm can cause a slight delay in the time of hydrocephalus onset in the endovascular series (not statistically significant). Long-term follow-up studies involving higher numbers of subjects are needed to better demonstrate this issue.
authors.affiliation: Department of Neurosciences and Reproductive and Odontostomatological Sciences Division of Neurosurgery, Università degli Studi di Napoli Federico II , Naples, Italy.
authors.forename: Michelangelo
authors.initials: M
authors.lastname: Gangemi
authors.affiliation: Department of Neurosciences and Reproductive and Odontostomatological Sciences Division of Neurosurgery, Università degli Studi di Napoli Federico II , Naples, Italy.
authors.forename: Luigi Maria
authors.initials: LM
authors.lastname: Cavallo
authors.affiliation: Department of Neurosciences and Reproductive and Odontostomatological Sciences Division of Neurosurgery, Università degli Studi di Napoli Federico II , Naples, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Di Somma
authors.affiliation: Department of Neurosurgery, Treviso Regional Hospital-University of Padova , Treviso, Italy.
authors.forename: Grazia Marina
authors.initials: GM
authors.lastname: Mazzucco
authors.affiliation: Department of Human Pathology and Oncology, University of Florence, Units of Neurosurgery Careggi Hospital , Florence, Italy.
authors.forename: Paolo Sebastiano
authors.initials: PS
authors.lastname: Bono
authors.affiliation: Ospedale S. Maria della Misericordia- S. Andrea delle Fratte, Università degli Studi di Perugia , Perugia, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Ghetti
authors.affiliation: Department of Neuroscience and Neurosurgery, San Bortolo Hospital , Vicenza, Italy.
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Zambon
keywords: Endovascular Treatment; Hydrocephalus; Intracranial Aneurysm; Microsurgical Treatment; Multicenter Study