title: Ventriculoperitoneal shunt placement in poor-grade patients with chronic normal pressure hydrocephalus after aneurysmal subarachnoid haemorrhage.
abstract: OBJECTIVE
  The aim of this study was to analyse the shunt placement in patients who had normal pressure hydrocephalus after poor-grade aneurysmal subarachnoid haemorrhage (aSAH).
  
  
  METHODS
  Patients diagnosed with NPH after poor-grade aSAH were divided into a treatment group and control group, based on whether they had received ventriculoperitoneal shunt placement. The treatment group was then divided into an improvement group and non-improvement group according to their recovery. The Glasgow Outcome Scale and Mini Mental Scale Examination were used for 3 month and 1 year follow-up rehabilitation measures.
  
  
  RESULTS
  Of the 46 total patients, significant improvement was observed at the 3 month and 1 year follow-ups (p < 0.01) after shunt implantation in the treatment group compared to the control group. Furthermore, patients who were younger (p = 0.022), had better neurological function (higher Glasgow Coma Score, p < 0.01) and less severe hydrocephalus (lower EI, p < 0.01) appears to be more likely to benefit from the shunt.
  
  
  CONCLUSIONS
  Patients who had NPH due to poor-grade aSAH would benefit from shunt placement when given the correct candidates and timely management of shunt malfunction. Additionally, the curative effect of the shunt should have been regarded as a long-term goal of rehabilitation in these patients.
authors.affiliation: a Department of Neurosurgery .
authors.forename: Hai
authors.initials: H
authors.lastname: Yu
authors.affiliation: b Department of Ophthalmology .
authors.forename: Min
authors.initials: M
authors.lastname: Yang
authors.affiliation: c Department of Vascular Surgery , Tongde Hospital of Zhejiang Province , Hangzhou , P.R. China , and.
authors.forename: Xiaobo
authors.initials: X
authors.lastname: Zhan
authors.affiliation: d Department of Neurosurgery , First Affiliated Hospital, College of Medicine, Zhejiang University , Hangzhou , P.R. China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: d Department of Neurosurgery , First Affiliated Hospital, College of Medicine, Zhejiang University , Hangzhou , P.R. China.
authors.forename: Jian
authors.initials: J
authors.lastname: Shen
authors.affiliation: d Department of Neurosurgery , First Affiliated Hospital, College of Medicine, Zhejiang University , Hangzhou , P.R. China.
authors.forename: Renya
authors.initials: R
authors.lastname: Zhan
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D005260:Female; D023261:Glasgow Outcome Scale; D006801:Humans; D006850:Hydrocephalus, Normal Pressure / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D013345:Subarachnoid Hemorrhage / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D017287:Ventriculoperitoneal Shunt / Q000379:methods*
keywords: Aneurysmal subarachnoid haemorrhage; normal pressure hydrocephalus; prognostic factors; ventriculoperitoneal shunt