Chronic hydrocephalus that requires shunting in aneurysmal subarachnoid haemorrhage [a-SAH]: its impact on clinical outcome

Background Chronic hydrocephalus is a common occurrence following aneurismal subarachnoid haemorrhage [a-SAH] but its impact on neurological outcome has not been re reviewed systematically.

Patients and methods One hundred and eleven patients were recruited from a prospectively collected a-SAH registry over a 3-year period between 2002 and 2004. Their 6-month extended Glasgow Outcome Scale [GOSE] scores were correlated with routine clinical data and the need for CSF shunting [chronic hydrocephalus that required shunting, CHS].

Results Thirty patients with CHS were identified and they were associated with an initial poor WFNS grading [median 4 versus 2, p=0.028]. Among patients with poor WFNS grading, CHS was associated with a better GOSE [median 4 versus 2, p=0.041] and among patients with good WFNS grading, CHS paradoxically was associated with a poor GOSE [median 3.5 versus 7, p=0.016]. Conclusion The relationships between CHS and GOSE in a-SAH were complex. Their true clinical significance requires a more in-depth prospective study.