BackgroundAcute hydrocephalus can cause neurological deterioration after aneurysmal subarachnoid hemorrhage (aSAH). Predicting which patient would require shunting is challenging.MethodsThis prospective study was conducted upon twenty patients who suffered acute hydrocephalus due to subarachnoid hemorrhage of ruptured aneurysms. Surgical or non-surgical management of hydrocephalus was conducted. Glasgow Coma scale (GCS) was assessed, and hydrocephalus was graded by bicaudate index. Fisher grade was determined from CT scan. Aneurysm site was determined by conventional or CT angiography. Either surgical clipping or endovascular coiling of aneurysms was performed.ResultsInitially, 3 (15%) patients had emergency CSF diversion on admission due to poor GCS on arrival. Initially, the remaining 17 patients were managed conservatively. Five patients did not require any intervention. Twelve patients had external ventricular drainage placement, 4 were weaned, and 8 failed weaning. High bicaudate index (> 0.2) correlated with shunting. Aneurysm site correlated well with shunting (ACoA or PCoA).ConclusionsPatients with fair GCS can be managed conservatively. Any deterioration warrants shifting to CSF diversion. Higher bicaudate index will usually need CSF diversion. The value of Fisher carries no significant value. Aneurysm location (ACoA or PCoA) correlates with an increased incidence of ventriculoperitoneal shunt placement.

Introduction This is a retrospective study to find out the prevalence of symptoms before and after cervical laminectomy surgery in a series of patients with cervical spondylotic myelopathy (CSM). Material and Methods A total of 45 patients with CSM (29 males and 16 females; mean age, 54.2 year) treated by laminectomy with or without posterior fixation were included. Cases were followed up for an average of 26 months. The modified Japanese Orthopedic Association (mJOA) score for CSM to evaluate the severity of myelopathy, the prevalence was assessed by the presence or absence of a full mJOA score for each function. The persistence rate (%) of each function impairment is (postoperative prevalence/preoperative prevalence × 100) was also assessed postoperatively. Results The preoperative motor function impairment prevalence was 74.2% in the upper extremities and 78.4% in the lower extremities, whereas the sensory function impairment was 58.2%. The preoperative prevalence of urinary bladder function impairment was 41.2%. The persistence rate of motor function impairment was 51.2% in the upper extremities and 73.5% in the lower extremities, whereas that of sensory function impairment was 74.2%. The urinary bladder function impairment persistence rate was 48.2%. Conclusion The preoperative prevalence of motor function impairment in the upper and lower extremities is higher than that of other function impairments, and impairments in lower extremity motor function and sensory function often persist after surgery.