Research Of Risk Factors And Prognostic Factors In Patients With Chronic Hydrocephalus After Aneurysmal Subarachnoid Hemorrhage

Objective To analyze the predictors related to chronic hydrocephalus in patients with aneurysmal subarachnoid hemorrhage (aSAH), and then make a forward inquiry into the curative effect of these risk factors on prognosis of a ventriculo-peritoneal shunt, providing the basis of improving the efficacy from pathogenesis to management of these patients.Methods A consecutive cohort of202patients was evaluated from June2009to June2012. The study population were divided into two groups according to the diagnosis of chronic hydrocephalus; further, the hydrocephalus patients were also divided into two groups based on outcomes after6months to2years’ follow-up. Relevant statistical analyses were presented to identify the significance of risk factors and prognostic factors associated with chronic hydrocephalus.Results From among202patients,55(27.2%) developed shunt-dependent Hydrocephalus, in the univariate analysis, age, pre-existing hypertension, Glasgow Coma Scale (GCS), Hunt-Hess grade, modified Fisher grade, posterior circulation, re-bleeding, acute hydrocephalus, intraventricular hemorrhage (IVH), vasospasm, nosocomial meningitis, neurosurgical clipping, decompressive craniectomy (DC), external ventricular drainage (EVD) and duration of EVD were significantly related to chronic hydrocephalus; moreover, age, pre-existing hypertension, posterior circulation, acute hydrocephalus, IVH, and DC were independent predictors in the multivariate analysis. Additionally, among40hydrocephalus patients, who completed the follow-up,26(65.0%) improved after undergoing a V-P shunt. The age, Hunt-Hess grade, GCS, nosocomial meningitis, and duration of EVD could be the prognosticators of a V-P shunt.Conclusions Hydrocephalus after aSAH seems to have a multifactorial etiology. Patients who were older, with worse mental function status on admission, nosocomial meningitis, and longer duration of EVD are susceptible to shunt-dependent hydrocephalus due to ruptured intracranial aneurysm and also have unfavorable outcomes after a V-P shunt. Timely and appropriate treatment can benefit such patients in recovery.