Various problems related to the occurrence of hydrocephalus after subarachnoid hemorrhage caused by ruptured cerebral aneurysm]

A CT scan done on admission showed widening of the ventricular system in 56 (34%) out of 164 patients with a ruptured intracranial aneurysm. 82% of the patients were admitted within 5 days after the bleeding. Those with hydrocephalus were often in a poor clinical condition (grades 3-5 Hunt and Hess, p less than 0.01) with up-going plantars twice as frequently encountered as in the remaining group. Widening of the ventricles adversely affected the prognosis. With hydrocephalus rebleeding was more frequent (p less than 0.02) and so was the ischaemic neurological deficit, whereas long-term treatment results were worse (p less than 0.01) with a double mortality rate (p less than 0.02). Hydrocephalus was more frequent in older patients (p less than 0.001 and in those with posterior fossa aneurysms (p less than 0.005). It was also promoted by diffuse and extensive bleeding into the subarachnoid space (p less than 0.01) and by intraventricular haemorrhage (p less than 0.0001). Three patients were treated with ventricular drainage.