The Result of Ventriculo-Peritoneal(V-P) Shunt in Patients with Chronic Hydrocephalus after Aneurysmal Subarachnoid Hemorrhage: Preliminary Study

Chronic hydrocephalus is a frequent occurrence after aneurysmal subarachnoid hemorrhage. 14 patients with chronic hydrocephalus and treating with shunting procedure were retrospectively reviewed. Chronic hydrocephalus after aneurysmal subarachnoid hemorrhage was usually recognized when gradual deterioratsm of consciousnes, unexplanied aggrvation of occuring neurologic defists, especially urinary incontinence.

Two-hundred consecutive patients with aneurysmal SAH were admitted to the neuro-surgical department Ewha Womans university Mok-Dong Hospital between fanuary 1994 and fanuary 2001, in all the patients aneurysms clipping was carried out. Among then 14 patient to chronic hydrocephalus following aneurysmal SAH and treating with shunting procedure were reviewed according to consionsnes level(Hunt-Hess classification), amonts of SAH(grading system of Fisher), sites and incidence. The chronic hydrocephalus was diagnosed CT findings in the clinical findings ; deterioration of level of consiousness, aggravation of neurologic deficits and urinary incontinence.

The average age of patients was 51 and predominant in women(man : woman=4 : 10). The incidence of chronic hydrocephalus was 7% and the aneurysmal sites were followings : posterior communicating artery(7), anterior communicating artery(4), and internal carotid artery bifuncation, middle cerebral artery and superior cerebellar artery were 1 respectiviy. According Hunt-Hess Grades were following ; grade I, II, III and IV=1, 6, 3 and 4. The number of patients according to Fisher's grading system were following ; grade 2, 3, and 4=6, 7, and 1. The outcomes by Glasgow assessment were the followings ; Score 5 and 4=9 and 5.

The response to shunting procedure in symptomatic patients of Chronic hydrocephalus following aneurysmal SAH. good in all patients.