OBJECTIVETo study the role of transforming growth factor-β1 (TGF-β1) levels and other risk factors in the occurrence of chronic hydrocephalus after aneurysmal subarachnoid hemorrhage (aSAH).

METHODSPatients treated for aSAH in our hospital between January, 2007 and June, 2012 were divided into non-hydrocephalus group and hydrocephalus group. TGF-β1 levels in the cerebrospinal fluid (CSF) were compared between the two groups at different time points. A retrospective analysis was conducted to identify the potential risk factors for chronic hydrocephalus, which were subsequently confirmed by Logistic regression analysis.

RESULTSOf the 129 patients enrolled, 16 (12.4%) developed chronic hydrocephalic with an average diagnosis time of 31.6∓17.0 days. In patients with chronic hydrocephalus, TGF-β1 level in the CSF increased significantly on the 13th day following aSAH (P<0.05). Retrospective analysis showed that the patients with hydrocephalus and those without had significant differences in history of hypertension, times of SAH, Hunt-Hess classification, ventricular expansion, aneurysm position, Fisher classification, ventricular hemorrhage score and intracranial infections (P<0.05). Logistic regression analysis identified ventricular expansion, aneurysm position, Fisher classification, ventricular hemorrhage score and postoperative intracranial infections as significant risk factors for the occurrence of chronic hydrocephalus (P<0.05).

CONCLUSIONSIn adult patients with aSAH, the risk factors for chronic hydrocephalus include ventricular expansion, aneurysm position, Fisher classification, ventricular hemorrhage score and postoperative intracranial infections. These risk factors can have greater clinical value than TGF-β1 levels in the CSF in predicting the occurrence of chronic hydrocephalus following aSAH.