Does Neurosurgical Clipping or Endovascular Coiling Lead to More Cases of Delayed Hydrocephalus in Patients with Subarachnoid Hemorrhage?.
10.7461/jcen.2018.20.2.87
- Author:
Tae Oong EOM
1
;
Eun Suk PARK
;
Jun Bum PARK
;
Soon Chan KWON
;
Hong Bo SIM
;
In Uk LYO
;
Min Soo KIM
Author Information
1. Department of Neurosurgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea. kist1817@gmail.com
- Publication Type:Original Article
- Keywords:
Hydrocephalus;
Subarachnoid hemorrhage;
Aneurysm;
Cerebrospinal fluid
- MeSH:
Aneurysm;
Brain;
Cerebrospinal Fluid;
Drainage;
Humans;
Hydrocephalus*;
Incidence;
Subarachnoid Hemorrhage*;
Surgical Instruments
- From:Journal of Cerebrovascular and Endovascular Neurosurgery
2018;20(2):87-95
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: We investigated whether clipping or endovascular treatment (EVT) can reduce the incidence of delayed hydrocephalus. We also investigated whether additional procedures, namely lumbar drainage and extra-ventricular drainage (EVD), decrease the incidence of delayed hydrocephalus in patients with subarachnoid hemorrhage (SAH). MATERIALS AND METHODS: One-hundred and fifty-two patients who had undergone an operation for SAH were enrolled in this study. Clinical data, radiological data, and procedural data were investigated. Procedural data included the operating technique (clipping vs. EVT) and the use of additional procedures (no procedure, lumbar drainage, or EVD). Delayed hydrocephalus was defined as a condition in which the Evan's index was 0.3 or higher, as assessed using brain computed tomography more than 2 weeks after surgery, requiring shunt placement due to neurological deterioration. RESULTS: Of the 152 patients, 45 (29.6%) underwent surgical clipping and 107 (70.4%) underwent EVT. Twenty-five (16.4%) patients developed delayed hydrocephalus. Age (p = 0.019), procedure duration (p = 0.004), and acute hydrocephalus (p = 0.030) were significantly correlated with the incidence of delayed hydrocephalus. However, the operation technique (p = 0.593) and use of an additional procedure (p = 0.378) were not significantly correlated with delayed hydrocephalus incidence. CONCLUSION: No significant difference in the incidence of delayed hydrocephalus was associated with operation technique or use of an additional procedure in patients with SAH. However, delayed hydrocephalus was significantly correlated with old age, long procedural duration, and acute hydrocephalus. Therefore, we recommend that additional procedures should be discontinued as soon as possible.
