The Causation And Treatment To Hydrocephalus Following Subarachniod Hemorrage(the Report Of181Case)

Object:Based on hydrocephalus after aneurysmal subarachnoid hemorrhagestudied, to improve the cure rate of the patients.Methods:2008September to2011September in our hospital operation and interventi-onal treatment of181cases of subarachnoid hemorrhage (SAH), in whichconcurrent hydrocephalus (acute or chronic) in48cases,48cases of thisgroup,22were male,26female patients, age18-78years old.All of the patients in the hospital according to the severity of the6h14dadept operation or interventional therapy, line the pterional approach orimproved pterional approach operation treatment of aneurysms in26cases (allaneurysms were in microsurgical operation of direct clipping). Percutaneousinterventional embolization for the treatment of22cases of patients withoperation (both in the pathogenesis of3D complete embolization, duringoperation without aneurysm rupture).Result:At discharge, good results are divided into:1good;2, with mild residual;3,severe disability,4death;. At discharge statistic analysis of results, will be goodand residual light for good prognosis, will severely disabled and deathattributed to poor prognosis.After treatment,33cases had a good recovery,8cases of residual light,severe disability in7cases,0cases of death.Conclusion: Through this group of181patients retrospectively analysis, the followingconclusions can be drawn:1. acute hydrocephalus and its pathogenesis is subarachnoid and cerebralpool, intraventricular blood affects midbrain aqueduct, Monro hole, basalcistern and even whole intraventricular and subarachnoid cerebrospinal fluidcirculation, leading to the circulation of the cerebrospinal fluid pathwayobstruction. Chronic hydrocephalus is mainly due to intraventricularhemorrhage changed circulation of cerebrospinal fluid dynamics, and in thelater lead to serious within the subarachnoid space fibrosis cause.2. hydrocephalus risk factors include age, the position of the artery,anddiabetes mellitus, admission blood pressure increased, the initial CTexamination of ventricular enlargement and other relevant.3. As patients with Hunt-hess classification and Fisher levels increased,causing acute hydrocephalus subsequently increased probability of change.4. following aneurysmal subarachnoid hemorrhage hydrocephalusprevention treatment should first onset of allergic attention, its prevention andtreatment concept throughout the treatment period, the conservative treatment,prevention of invasive operation and operation treatment to reduce its incidence,improve the cure rate.5. chronic hydrocephalus shunt in treatment choice for V-P, SAH afterapproximately2week after cerebrospinal fluid is basic and normal, some casesmay be asymptomatic, to observe, in children and the special physique, can beconsidered the lateral ventricle-sagittal sinus shunt for treatment ofhydrocephalus.On hydrocephalus after subarachnoid hemorrhage prevention andtreatment, still some problems yet to be solved, we also need to work in the future to further research and discussion.