Background: The predictors of shunt dependency such as amount of subarachnoid blood, acute hydrocephalus (HC), mode of aneurysm repair, clinical grade at admission and cerebro spinal fluid (CSF) drainage in excess of 1500 ml during the 1st week after the subarachnoid hemorrhage (SAH) have been identified as predictors of shunt dependency. Therefore our main objective is to identify predictors of CSF shunt dependency following non-traumatic subarachnoid hemorrhage.
Methods: We performed a retrospective study including patients from January 1st 2012 to September 30th 2014 between 16 and 89 years old and had a non-traumatic subarachnoid hemorrhage in cranial computed tomography (CCT). We excluded patients with the following characteristics: Patients who died 3 days after admittance, lesions in brainstem, previous surgical treatment in another clinic, traumatic brain injury, pregnancy and disability prior to SAH.We performed a descriptive and comparative analysis as well as a logistic regression with the variables that showed a significant difference ( < 0.05). Hence we identified the variables concerning HC after non traumatic SAH and its correlation.
Results: One hundred and seven clinical files of patients with non-traumatic SAH were analyzed. Twenty one (48%) later underwent shunt treatment. Shunt patients had significantly clinical and corroborated with doppler ultrasonography vasospasmus ( = 0.015), OR = 5.2. The amount of subarachnoidal blood according to modified Fisher grade was ( = 0.008) OR = 10.9. Endovascularly treated patients were less often shunted as compared with those undergoing surgical aneurysm repair ( = 0.004).
Conclusion: Vasospasmus and a large amount of ventricular blood seem to be a predictor concerning hydrocephalus after non-traumatic SAH. Hence according to our results the presence of these two variables could alert the treating physician in the decision whether an early shunt implantation < 7 days after SAH should be necessary.
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http://dx.doi.org/10.1186/s13037-018-0160-6 | DOI Listing |
Cureus
December 2024
Neurosurgery, Hospital de Braga, Braga, PRT.
Introduction A large majority of spontaneous subarachnoid hemorrhages (SAH) are attributed to aneurysm rupture, though the cause remains unknown in a notable percentage of cases. Non-aneurysmal SAH (naSAH) is generally thought to follow a more benign clinical course than aneurysmal SAH (aSAH); however, similar complications may occur, and poor outcomes are still possible. Given the limited research on naSAH, this study aims to characterize these patients and correlate clinical and radiographic findings with outcomes.
View Article and Find Full Text PDFBrain Sci
November 2024
School of Medicine, New York Medical College, Valhalla, NY 10595, USA.
Background/objectives: Recent studies reveal an "obesity paradox", suggesting better clinical outcomes after intracranial hemorrhage for obese patients compared to patients with a healthy BMI. While this paradox indicates improved survival rates for obese individuals in stroke cases, it is unknown whether this trend remains true across all forms of intracranial hemorrhage. Therefore, the objective of our study was to investigate the incidence, characteristics, and outcomes of hospitalized obese patients with intracranial hemorrhage.
View Article and Find Full Text PDFJ Anesth Analg Crit Care
January 2025
Department of Emergency Surgery and Trauma, Anesthesia and Intensive Care Unit, Bufalini Hospital, Azienda Unità Sanitaria Locale (AUSL) Della Romagna, Cesena, Italy.
Patients admitted to intensive care unit (ICU) after non-traumatic subarachnoid hemorrhage (SAH) represent a group with distinctive characteristics and few data are available on long-term outcome in this population. We conducted a single-center retrospective study in an Italian intensive care unit. All patients with non-traumatic SAH (ICD-9-CM Diagnosis Code 430) admitted to ICU were included.
View Article and Find Full Text PDFJ Clin Neurosci
December 2024
Department of Neurological Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.
Background: Aneurysmal subarachnoid hemorrhage (aSAH) carries a high economic cost and clinical morbidity in the United States. Beyond prolonged admissions and poor post-injury functional status, there is an additional cost of chronic shunt-dependent hydrocephalus for many aSAH patients. Adjuvant lumbar drain (LD) placement has been hypothesized to promote clearance of subarachnoid blood from the cisternal space, with an ultimate effect of decreasing shunt placement rates.
View Article and Find Full Text PDFAcute Med Surg
December 2024
Department of Emergency, Critical Care, and Disaster Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama University Okayama Japan.
Aim: Vertebral artery dissection (VAD) is a rare cause of non-traumatic subarachnoid hemorrhage (SAH) with significant clinical implications. This study compared the clinical characteristics and outcomes of SAH from intracranial VAD rupture to those from other etiologies, primarily aneurysmal rupture.
Methods: This single-center retrospective cohort study at Okayama University Hospital included patients with non-traumatic SAH diagnosed between 2019 and 2023.
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