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Hydrocephalus Following Aneurysmal Subarachnoid Hemorrhage

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Cerebrospinal Fluid Disorders

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Abstract

Acute hydrocephalus following subarachnoid hemorrhage (SAH) is a commonly encountered neurosurgical entity, occurring in up to two-thirds of patients. Clinical symptoms and radiographic findings consistent with hydrocephalus in the acute setting of SAH can typically be temporarily managed with an external ventricular drain (EVD). Numerous risk factors predictive of the need for permanent cerebrospinal fluid (CSF) diversion have been identified, including temporary ventriculostomy, SAH severity, age, and in-hospital complications. Nonetheless, following the initial acute phase of SAH, placement of a ventriculoperitoneal (VP) shunt may be warranted if there is evidence of neurologic or radiographic decline with ventriculostomy challenge and is typically required in 20–50% of patients. Among patients that are successfully discharged without permanent CSF diversion, delayed development of chronic hydrocephalus occurs in 5% of patients and close follow-up for the initial year is recommended. Despite the severe nature of posthemorrhagic hydrocephalus, proper surveillance and management of this complication of SAH can ameliorate potential neurologic sequelae.

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Authors and Affiliations

  1. Department of Neurological Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA

    David L. Dornbos III, Luke G. F. Smith, Patrick P. Youssef, Ciarán J. Powers & Shahid M. Nimjee

  2. The Ohio State University Medical Center, Columbus, OH, USA

    Varun Shah & Nicholas Musgrave

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  1. David L. Dornbos III
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  2. Luke G. F. Smith
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  3. Varun Shah
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Correspondence to Shahid M. Nimjee .

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Editors and Affiliations

  1. Department of Neurological Surgery, Washington University School of Medicine, St. Louis Children’s Hospital, St. Louis, MO, USA

    David D. Limbrick Jr.

  2. Nationwide Children’s Hospital, Department of Neurosurgery, The Ohio State University College of Medicine, Columbus, OH, USA

    Jeffrey R. Leonard

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Dornbos, D.L. et al. (2019). Hydrocephalus Following Aneurysmal Subarachnoid Hemorrhage. In: Limbrick Jr., D., Leonard, J. (eds) Cerebrospinal Fluid Disorders . Springer, Cham. https://doi.org/10.1007/978-3-319-97928-1_13

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  • DOI: https://doi.org/10.1007/978-3-319-97928-1_13

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