We did notice a connection between the Hunt/Hess Score and gender of the patients and the naSAH that required a shunt therefore, these could be regarded as prognostic factors. Regarding the insertion of a shunt, the Fisher Classification, the presence of an aneurysm as well as its size and the presence of an ACOM aneurysm proved relevant. On the other hand, the gender and age of the patients did not have a prognostic value. However, the good news is that the overall standard of care for patients with hydrocephalus appears to have greatly improved over the last 10 years with the advent of better facilities for investigation, new approaches to treatment, and. 16% (58) of the patients in the first cohort and 11% (17) in the second cohort received a shunt.Ĭonclusion: Based on the analyzed data it seems that the Hunt/Hess Score, Fisher Classification, the presence of an aneurysm, an aneurysm of the posterior part of the circle of Willis, the size of the aneurysm and the presence of an anterior communication artery (ACOM) aneurysm are reliable prognostic factors in determining the necessity for an EVD. The second most common reason for being sued for negligence in neurosurgery is a problem related to hydrocephalus management (the first being spinal surgery). An EVD was placed in 44% (154) of the patients in the first cohort and 21% (33) in the second cohort. The Hunt/Hess Score as well as the Fisher Score in the aSAH cohort were on a mean value higher than in the naSAH cohort. In total, there were 304 aneurysms in the anterior part of the Circle of Willis and 48 in the posterior part. The mean age of the patients with aSAH was 55,2 years and of those with naSAH was 54,3 years. In the case of the non-aneurysmal SAH there was no relevant gender difference (75 women and 83 men). Results: Regarding the aneurysmal SAH we noticed a higher prevalence in women with 242 cases in comparison to men with 110 cases. The first cohort consisted of aneurysmal SAH -aSAH (352) and the second of non-aneurysmal SAH - naSAH (158). After applying the exclusion criteria (traumatic injury and spinal vascular malformation) we then divided the remaining 510 patients into 2 cohorts.
#DID LITTLE MASTERS FAADU SHUNT SERIES#
Methods and materials: This was a single center retrospective cohort study from January 2013 to December 2018 that was based on a series of 753 patients with a SAH diagnosed and treated at the Neuromedcampus of the Kepler University Hospital in Linz, Austria.
This study aims to find prognostic factors for the indication of placing either an EVD and /or a shunt. Till the present day there is little data that could allow for a correct assessment of the risk of developing a hydrocephalus after aSAH. Some patients may even require a permanent drainage, which can be achieved by inserting a shunt. The initial course of action is usually to place an external ventricular drain (EVD) for the cerebrospinal fluid. Introduction: Hydrocephalus is a common complication after a subarachnoid hemorrhage (SAH).
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