doiSerbia

Hydrocephalic risk factors after spontaneous subarachnoidal haemorrhaging of aneurysmal aetiology

Jovanović Vladimir (Institut za neurohirurgiju, Klinički centar Srbije, Beograd)
Tasić Goran (Institut za neurohirurgiju, Klinički centar Srbije, Beograd)
Đurović Branko (Institut za neurohirurgiju, Klinički centar Srbije, Beograd)
Janićijević Miloš (Institut za neurohirurgiju, Klinički centar Srbije, Beograd)

INTRODUCTION Hydrocephalus is one of the most significant complications of spontaneous subarachnoidal haemorrhaging that can be treated surgically. OBJECTIVE We analyzed risk factors that caused spontaneous subarachnoidal haemorrhaging. Patients were divided into two groups: shunt-dependent and shunt-independent. METHOD We retrospectively analyzed 174 patients (63 men and 111 women), surgically treated at the Institute of Neurosurgery of Clinical Center of Serbia in the period from January 2002 to January 2004. RESULTS The prevalence of hydrocephalus in patients with a shunt (shunt-dependent) was most significant in women (18%:9.5%), but not statistically significant (p>0.05). Concerning the significance of age (years), we found that hydrocephalus in patients with a shunt was most significant in older patients (p<0.025).The HiH and Fisher grading were not statistically significant in our study (p>0.05%). In patients with intraventricular haemorrhaging (29.3%:10.5%) and vasospasms (34.6%:6.5%), the prevalence of shunt-dependent hydrocephalus was statistically very significant (p<0.005; p<0.001). The frequency of ventriculomegania in the initial CT scan was greater for patients with a confirmed diagnosis, but of no statistical significance (p>0.05). The prevalence of shunt-dependent hydrocephalus with aneurysms in the a. basillaris basin was 47.4%, with multiple aneurysms 17.2%, and with aneurysms of the anterior segment 9.5%, which represents a statistically significant difference (p<0.001). CONCLUSION We discovered that hydrocephalus, as a complication of spontaneous subarachnoidal haemorrhaging, was most frequent in patients older than 50 years, manifesting in ventricular haemorrhaging, vasospasm, and aneurysms of the posterior segment.

Keywords: hydrocephalus, subarachnoidal haemorrhage, aneurysm, risk factors