[Effect of drainage of the cerebrospinal fluid at the acute period of aneurysmal subarachnoid hemorrhage on the formation of hydrocephalus].

ABSTRACT

OBJECTIVE: To discuss the effect of drainage of the cerebrospinal fluid (CSF) at acute period after aneurysmal subarachnoid hemorrhage (SAH) on the formation of hydrocephalus. METHODS: Eighty-four patients with aneurysmal SAH were randomly divided into two groups according to therapeutic regimen. Forty-two cases in specific treatment group were given intravascular embolism at the acute period of hemorrhage after a ruptured aneurysm, then CSF was drained immediately. Forty-two cases were in conventional expectant treatment group. Clinical data and incidence of hydrocephalus of specific treatment group and conventional expectant treatment group were analyzed. RESULTS: Clinical data did not show any differences between two groups, so they could be compared (all P>0.05). The incidence rate of acute hydrocephalus in specific treatment group was 7.14% (3/42 cases), that of subacute hydrocephalus was 4.76% (2/42 cases), and that of chronic hydrocephalus was 16.67% (7/42 cases). The total incidence rate was 28.57%. In conventional expectant treatment group, the incidence rate of acute hydrocephalus was 23.81% (10/42 cases), incidence of subacute hydrocephalus was 9.52% (4/42 cases), and that of chronic hydrocephalus was 35.71% (15/42 cases), and total incidence rate was 69.05%. There was significant difference between specific treatment group and conventional expectant treatment group in incidence of acute and chronic hydrocephalus (acute chi (2)=4.46, chronic chi (2)=3.94, both P<0.05), and there was no difference in subacute hydrocephalus between two groups (chi (2)=0.72, P>0.05), but significant difference was found in total incidence rate between two groups (chi (2)=13.77, P<0.01). CONCLUSION: Embolization of the intracranial aneurysm with interventional treatment at the acute hemorrhage stage (within 7 days) for the aneurysmal SAH, followed by immediate drainage of CSF can prevent hydrocephalus or alleviate hydrocephalus, and the treatment plays a significant role in the formation and development of hydrocephalus.