Comparison of Clinical Usefulness of Lumboperitoneal Shunt with Ventriculoperitoneal Shunt for Treating Chronic Hydrocephalus in Ruptured Intracranial Aneurysm

ABSTRACT

Lumboperitoneal(LP) shunt has the advantage of complete extracranial surgical management, minimizing intracranial complication. The clinical usefulness of LP shunt in selecting patients with communicating hydrocephalus after aneurysmal subarachnoid hemorrhage(SAH) was compared with that of ventriculoperitoneal(VP) shunt. Chronic hydrocephalus was defined as clinically and radiographically demonstrated hydrocephalus that lasted 2 weeks or longer after the original hemorrhage and required shunting. Thirty four patients(9.6%) underwent shunt placement (LP shunt 22, VP shunt 12). There was no statistically significant difference in age, Hunt-Hess grade, Fisher grade, hypertension, vasospasm, shunt interval, Evan's index, intracranial pressure, and periventricular lucency between patients with a LP shunt and those with a VP shunt. An clinical improvement of 9 cases(40.9%) in patients with a LP shunt and 11 cases(91.6%) in a VP shunt were seen(p<0.005). Our findings suggest that VP shunt would be the better choice of treatment compared to LP shunts in treating chronic hydrocephalus after aneurysmal SAH.