Extent of subarachnoid hemorrhage and development of hydrocephalus
Keywords:Hydrocephalus, Subarachnoid hemorrhage, Fisher scale
AbstractBackground and objective Factors associated with the developmentof acute hydrocephalus following subarachnoidhemorrhage are not fully elucidated. The goal of this studywas to present the relative predictive values of Hunt-Hessgrade and Fischer score in determining the propensity fordeveloping post-hemorrhage hydrocephalus and to documentthe frequency of acute and chronic hydrocephalus followingsubarachnoid hemorrhage. Patients and methodsOur study encompassed 102 patients with anurismal subarachnoidhemorrhage. The Hunt-Hess scale was used forthe initial neurological status assessment and the extent ofsubarachnoid hemorrhage was graded based on the Fisherscale. Assessment of hydrocephalus was made on the basisof the size of both temporal horns, the ratio of FH/ID andEvan’s ratio. Results Thirty-two percent of patients exhibitedhydrocephalus requiring CSF diversion procedure. Externalventricular drainage was performed in 29 % of patients forearly hydrocephalus. Seventy percent of patients with acutehydrocephalus requiring external ventricular drainage weregraded as 3, 4 or 5 according to the Hunt and Hess scale onadmission, in contrast to 58 percent of patients without hydrocephalus.Ninety-three percent of patients with hydrocephaluswere graded as 3 and 4 according to Fisher grade oninitial CT scan, in contrast to 83% of patients without hydrocephalus.Conclusion Even though an increased frequency ofhydrocephalus was noted among patients that presented withhigher Fisher and Hunt-Hess grades, none of these gradeswere shown to bear a statistically significant predictive valuein determining the propensity for the development of hydrocephalus.
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