Related Factors And Prevention Of Chronic Hydrocephalus After Clipping Of The Ruptured Intracranial Aneurysms

Purpose To explore the related factors of chronic hydrocephalus after clipping the ruptured intracranial aneurysms.Method A retrospective analysis was conducted from July 2014 to June 2017 about aSAH in 671 patients with general anesthesia downlink aneurysm clipping in the neurosurgery of The First Affiliated Hospital Of Soochow University,according to the selection criteria and selection criteria,469 patients selected were retrospectively analyzed by the research standard.And according to the CT the two weeks after aneurysm clipping and postoperative CT review found that there was 52 chronic hydrocephalus patients,and divided the patients into chronic hydrocephalus group and the group without chronic hydrocephalus.According to the reference literature and the treatment in the hospital,selected gender,age,Hunt-Hess classification,the operation time,hypertension history,diabetes,bleeding frequency,the bleeding responsibility artery,hyponatremia,lumbar cistern drainage,fenestration of lamina terminalis,intracranial infection,the 13 related probabilistic risky factors about chronic hydrocephalus carrying on statistical analysis,and the related factors of statistically significant multiariable Logistic regression analysis,Finally,the risk factors of chronic hydrocephalus were obtained and analyzed.Results The rate of chronic hydrocephalus after clipping the ruptured intracranial aneurysms was 11.08%,and the related factors of chronic hydrocephalus occurred mainly include: age,Hunt-Hess classification,bleeding frequency,intraventricular hemorrhage,lumbar cistern drainage,fenestration of lamina terminalis,intracranial infection,seven factors in the presence of chronic hydrocephalus significantly statistical difference in contrast,and through multiple Logistic regression analysis the factors of preoperative Hunt-Hess classification is the most relevant,then followed by age,bleeding frequency,intraventricular hemorrhage.And intracranial infection were excluded as the main risk factors.The protective measures for prevention of chronic hydrocephalus can be prevented by lumbar cistern drainage and fenestration of lamina terminalis.Conclusion The occurrence of chronic hydrocephalus is the result of multiple factors,including the high age patient,the high level Hunt-Hess classification,repeatedly hemorrhage,and the hemorrhage of the ventricle.For intraventricular hemorrhage more on admission,the higher level Hunt-Hess classification patients,as far as possible to clean up the remnant blood of the brain pool in the operation,to carry out the fenestration of lamina terminalis intraoperation and to carry out the lumbar cistern drainage after operation has a positive effect on reducing the incidence of Chronic hydrocephalus after clipping of aneurysmal subarachnoid hemorrhage.