Ventriculoperitoneal shunt placement in poor-grade patients with chronic normal pressure hydrocephalus after aneurysmal subarachnoid haemorrhage

Brain Inj. 2016;30(1):74-8. doi: 10.3109/02699052.2015.1075153. Epub 2015 Dec 29.

Abstract

Objective: The aim of this study was to analyse the shunt placement in patients who had normal pressure hydrocephalus after poor-grade aneurysmal subarachnoid haemorrhage (aSAH).

Methods: Patients diagnosed with NPH after poor-grade aSAH were divided into a treatment group and control group, based on whether they had received ventriculoperitoneal shunt placement. The treatment group was then divided into an improvement group and non-improvement group according to their recovery. The Glasgow Outcome Scale and Mini Mental Scale Examination were used for 3 month and 1 year follow-up rehabilitation measures.

Results: Of the 46 total patients, significant improvement was observed at the 3 month and 1 year follow-ups (p < 0.01) after shunt implantation in the treatment group compared to the control group. Furthermore, patients who were younger (p = 0.022), had better neurological function (higher Glasgow Coma Score, p < 0.01) and less severe hydrocephalus (lower EI, p < 0.01) appears to be more likely to benefit from the shunt.

Conclusions: Patients who had NPH due to poor-grade aSAH would benefit from shunt placement when given the correct candidates and timely management of shunt malfunction. Additionally, the curative effect of the shunt should have been regarded as a long-term goal of rehabilitation in these patients.

Keywords: Aneurysmal subarachnoid haemorrhage; normal pressure hydrocephalus; prognostic factors; ventriculoperitoneal shunt.

MeSH terms

  • Aged
  • Case-Control Studies
  • Female
  • Glasgow Outcome Scale
  • Humans
  • Hydrocephalus, Normal Pressure / physiopathology
  • Hydrocephalus, Normal Pressure / surgery*
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Subarachnoid Hemorrhage / physiopathology
  • Subarachnoid Hemorrhage / surgery*
  • Treatment Outcome
  • Ventriculoperitoneal Shunt / methods*