Hidrocefalia posthemorragia subaracnoidea aneurismática: Factores predictivos / Post aneurismatic subarachnoid hemorrhage hydrocephalus: Predictive factors

ABSTRACT

Objective: To analyze the frequency of hydrocephalus in aneurismal subarachnoid hemorrhage and to establish its most frequently predictive factors. Material and method: Revision of 89 clinical records of patients with aneurismal SAH treated in our Service during years 2004 to 2006. We considered in their admission sex, age, Hunt/Hess clinical grade, fisher scale and the presence or not of hydrocephalus in CT, Glasgow com scale, and other co morbid factors as arterial hypertension and diabetes. Results: Age, hypertension and diabetes, demonstrated not to be strong associated with post aneurismal SAH acute hydrocephalus in our series. Hydrocephalus prevalence in males was similar to that in females, but it is interesting to mention that the 100 of cases treated surgically were females. We have found a firm relationship between Hunt/Hess and Fisher high scores at admission and the presence of ventricular blood invasion as well as great volume of it in the basal cisterns with the occurrence of acute hydrocephalus. Conclusion: Our results confirm the latest pathophysiological concepts that acute hydrocephalus post SAH is an obstructive entity, remarking the following as the principals predictive factors a) severe neurological deterioration at admission (Hunt – Hess 4/5), b) important amount of blood in subarachnoideal space and ventricular system (Fisher III/IV).