The Clinical Study Of The Effect Of Endplate Fistula On Chronic Hydrocephalus After Intracranial Aneurysm Surgery

Purpose:To investigate the influencing factors of chronic hydrocephalus after intracranial aneurysm rupture and the role of endplate fistula in prevention from chronic hydrocephalus during the operation of aneurysm clipping.Method:84 cases who undergoing the operation of aneurysm clipping in our hospital were collected in this study.These patients' Fisher grade were ?-?.According to whether receiving intraoperative endplate fistula these patients were divided into the fistula group(42 cases)and control group(42 cases).After 14-42 d,CT and MRI were used to evaluate the incidence of chronic hydrocephalus,and to find the influence factors of postoperative hydrocephalus.Result:(1)The whole incidence of chronic hydrocephalus after aneurysm clipping was 11.90%.The incidence of chronic hydrocephalus in the fistula group and in the control group was 11.90% and 26.19% respectively.There was significant difference in the incidence of chronic hydrocephalus after aneurysm clipping between two groups(P < 0.05).(2)a: In the patients of Fisher grade?,the difference in the incidence of chronic hydrocephalus between the fistula group and the control group was n't significant(P>0.05).In the patients of Fishe r grade ?,the incidence of chronic hydrocephalus in the fistula group was 11.76%,and the incidence in the control group was 23.52%.In the patients whose Fisher grade were ?,the incidence of chronic hydrocephalus after operation was 11.76%,and the incidence in the control group was 37.50%.There were statistical significance in chronic hydrocephalus in Fisher grade were ? and ?between two groups..b: The rate of the chronic hydrocephalus in the patients with intraventricular hemorrhage was 22.22% and the rate in the control group was 58.82%.There was statistical difference between two groups.c: There was no difference in the rate of chronic hydrocephalus among the patients who had residual hemorrhage of grade ?-? between two groups.The rate of chronic hydrocephalus in residual hemorrhage of grade ?-? in the fistula group and the control group was 18.75% and 42.11%.The difference between two groups was significant.d: The rate of chronic hydrocephalus in the patients with continuous lumbar cistern drainage was 14.75% and the rate without continuous lumbar cistern drainage was 30.43%.The difference between two groups was significant.There was no statistical difference between the fistula group and the control group.The rate of chronic hydrocephalus in the patients with intracranial infection was 57.15% and the rate in the patients without intracranial infection was 15.58%.There were significant differences between two groups.But in the fistula group and the control group,the incidence of chronic hydrocephalus rate was not statistically significant.Conclusion:In this study,many factors have effects on the chronic hydrocephalus after aneurysm clipping,such as age,Fisher grade,intraventricular hemorrhage,postoperative bleeding,postoperative residual intracranial infection,continuous lumbar cistern drainage.The endplate fistula in aneurysm clipping can effectively prevent chronic hydrocephalus,especially in the patients with Fisher Grade ?-?,intraventricular hemorrhage and residual hemorrhage.It can prevent chronic hydrocephalus,shorten hospital stay,reduce hospital charge and be worthy recommendation.