Journal article
Factors associated with hydrocephalus after subarachnoid hemorrhage. A report of the Cooperative Aneurysm Study
Archives of neurology (Chicago), Vol.46(7), pp.744-752
07/1989
DOI: 10.1001/archneur.1989.00520430038014
PMID: 2742543
Abstract
Hydrocephalus is an important complication of subarachnoid hemorrhage (SAH). We analyzed several factors possibly related to hydrocephalus following SAH in 3521 patients from the International Study on the Timing of Aneurysm Surgery. Hydrocephalus was diagnosed on admission computed tomographic (CT) scans in 15% of patients and was thought to be clinically symptomatic in 13.2% of patients. There was a 5.9% overlap between these groups. Using contingency table analysis, we found the following were significantly related to clinical hydrocephalus: increasing age; preexisting hypertension; admission blood pressure measurements; postoperative hypertension; admission CT findings of intraventricular hemorrhage, a diffuse collection of subarachnoid blood, and a thick focal collection of subarachnoid blood; posterior circulation site of aneurysm; focal ischemic deficits; use of antifibrinolytic drugs preoperatively; hyponatremia; admission level of consciousness; and a low score on the Glasgow outcome scale. Using discriminate factor analysis to predict clinical hydrocephalus, the most important variables in order were the following: CT hydrocephalus, intraventricular hemorrhage, admission level of consciousness, presubarachnoid hypertension, increasing age, subarachnoid blood noted on CT scan, posterior circulation aneurysm site, and hypertension postoperatively (canonical correlation = .399). We conclude that the development of hydrocephalus after SAH is multifactorial. Factors that compromise cerebrospinal fluid circulation acutely (eg, intraventricular hemorrhage, hemorrhage from a posterior circulation site of aneurysm, and diffuse spread of subarachnoid blood) contribute to the development of acute hydrocephalus. These same factors, plus the use of antifibrinolytic drugs preoperatively, are also important in the pathogenesis of clinical hydrocephalus, perhaps by promoting subarachnoid fibrosis.
Details
- Title: Subtitle
- Factors associated with hydrocephalus after subarachnoid hemorrhage. A report of the Cooperative Aneurysm Study
- Creators
- Neill R Graff-Radford - Department of Neurology, University of Iowa College of Medicine, Iowa CityJames TornerHarold P Adams JrNeal F Kassell
- Resource Type
- Journal article
- Publication Details
- Archives of neurology (Chicago), Vol.46(7), pp.744-752
- DOI
- 10.1001/archneur.1989.00520430038014
- PMID
- 2742543
- NLM abbreviation
- Arch Neurol
- ISSN
- 0003-9942
- eISSN
- 1538-3687
- Publisher
- American Medical Association; United States
- Language
- English
- Date published
- 07/1989
- Academic Unit
- Neurology; Epidemiology; Iowa Neuroscience Institute; Surgery; Injury Prevention Research Center; Neurosurgery
- Record Identifier
- 9983996091402771
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