Acute hydrocephalus and delayed cerebral infarction after aneurysmal subarachnoid hemorrhage

Masson, Axel; Boulouis, Grégoire; Janot, Kévin; Herbreteau, Denis; Cottier, J P; Bibi, Richard; Cohen, Clara; Obry, Sandra; Velut, Stéphane; Amelot, Aymeric; Ifergan, Héloïse

doi:10.1007/s00701-022-05321-8

Cited by 7 publications

(5 citation statements)

References 42 publications

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“…DCI will seriously affect the prognosis of aSAH patients ( 6 ). Consistent with previous studies, the presence of DCI in this study was associated with poor prognosis (14.56% of patients with good prognosis had DCI, and 47.58% of patients with poor prognosis had DCI, P < 0.05).…”

Section: Discussionmentioning

confidence: 99%

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Risk factors and predictive models of poor prognosis and delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage complicated with hydrocephalus

Wang

Zhang

et al. 2022

Front. Neurol.

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ObjectiveTo evaluate the correlation of serum biological markers and related scales to the occurrence of delayed cerebral ischemia and clinical prognosis in patients with aneurysmal subarachnoid hemorrhage (aSAH) complicated with acute hydrocephalus before admission.MethodsThe clinical data of 227 patients with pre-admission aSAH complicated with acute hydrocephalus admitted to Henan Provincial People's Hospital from April 2017 to December 2020 were retrospectively analyzed. Patients were grouped according to the presence or absence of delayed cerebral ischemia (DCI) after surgery and the prognosis at 6 months after discharge. Univariate and multivariable logistic regression analysis were performed to analyze the relationship between serum biological indicators combined with aneurysm related clinical score scale and the occurrence and prognosis of delayed cerebral ischemia. ROC curves and nomogram were drawn.ResultsMultivariable Logistic regression analysis showed that high Hunt-Hess grade and surgical clipping were independent risk factors for postoperative DCI (P < 0.05). Older age, higher Hunt-Hess grade, higher CRP and neutrophil levels were independent risk factors for poor prognosis at 6 months after surgery (P < 0.05). ROC curve analysis showed that the area under the curve (AUC) of Hunt-Hess grade and surgical method for predicting DCI in patients with aSAH combined with hydrocephalus after surgery were 0.665 and 0.593. The combined AUC of Hunt-Hess grade and surgical method was 0.685, the sensitivity was 64.9%, and the specificity was 64.7%. The AUC of CRP, neutrophil, age and Hunt-Hess grade for predicting poor prognosis in patients with aSAH combined with hydrocephalus at 6 months after surgery were 0.804, 0.735, 0.596, 0.757, respectively. The combined AUC of CRP, neutrophil, age, Hunt-Hess grade was 0.879, the sensitivity was 79%, and the specificity was 84.5%. According to the correction curve, the predicted probability of the nomogram is basically consistent with the actual probability.ConclusionHunt-Hess grade and surgical method are independent predictors of postoperative DCI in patients with aSAH complicated with hydrocephalus. “CRP,” “neutrophil,” “age” and “Hunt-Hess grade” at admission are independent predictors of clinical prognosis in patients with aSAH complicated with hydrocephalus. The combination of the above indicators has high predictive value.

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Section: Discussionmentioning

confidence: 99%

“…Delayed cerebral ischemia is one of the main causes of high mortality and morbidity ( 5 ). DCI is a clinical imaging syndrome that includes focal ischemia and/or cognitive impairment on CT/MRI and/or cerebral infarction ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

Risk factors and predictive models of poor prognosis and delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage complicated with hydrocephalus

Wang

Zhang

et al. 2022

Front. Neurol.

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“…5) is an independent prognostic risk factor for patients with aneurysms and exhibits similar prognostic predictive value as the Hijdra score. In 2019, a meta-analysis by van der Steen et al confirmed the significant association between the Hijdra scale and poor prognosis in SAH, particularly in cases of delayed cerebral ischemia, hydrocephalus, and cerebral vasospasm, which were independent predictors of prognosis at 6 months [ 16 , [20] , [21] , [22] , [23] ]. The prognostic value of the modified Hijdra score in predicting outcomes in patients with aneurysmal was supported by studies demonstrating its improved diagnostic efficacy.…”

Section: Discussionmentioning

confidence: 99%

The value of modified hijdra score in patients with aneurysmal subarachnoid hemorrhage

Wu,

Hu,

Liu

et al. 2024

Heliyon

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“…The bicaudate index, for example, was rst introduced by Barr et al in 1978 as a tool to assess Huntington diseases and brain atrophy on CCT scans [19]. Subsequently, it became a commonly used measure for the diagnosis of hydrocephalus in various neurosurgical patient cohorts, especially in patients with subarachnoid hemorrhage [22][23][24][25]. In contrast, the Evans' Index has been widely used as a neuroradiological additive to aid in the diagnosis of normal pressure hydrocephalus, and more recently has been assessed in combination with volumetric measurements [26][27][28][29].…”

Section: Discussionmentioning

confidence: 99%

Predicting the need for a cerebrospinal fluid Shunt implantation after spontaneous Intracerebral Hemorrhage: A challenging task

Khalaveh

Zeiser

Cho

et al. 2023

Preprint

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OBJECTIVE The development of persistent hydrocephalus in patients after spontaneous intracerebral hemorrhage (ICH) is still poorly understood and many variables predicting the need for a cerebrospinal fluid (CSF)-shunt have been described in the literature with varying results. The aim of this study is to find predictive factors for shunt dependency. METHODS We performed a retrospective, single-center study of 99 neurosurgically treated patients with spontaneous ICH. Variables, including age, Glasgow Coma Scale (GCS), intraventricular hemorrhage (IVH), location of hemorrhage, acute hydrocephalus and volumetric analysis of IVH, ICH and intraventricular CSF were compared between patients with and without CSF-shunt implantation. Furthermore, receiver operating characteristics (ROC) for ICH, IVH and intraventricular CSF volume parameters were calculated. RESULTS CSF-shunt implantation was performed significantly more often in patients after thalamic (p=0.03) and cerebellar ICH (p=0.04). Moreover, a lower ratio between the total hemorrhage volume and intraventricular CSF volume (p=0.007), a higher IVH distribution in the third ventricle and an acute hydrocephalus (p<0.001) with an increased intraventricular CSF volume (p<0.001) were associated with shunt dependency. Our ROC model demonstrated a sensitivity of 82% and a specificity of 65% to predict the necessity for a shunt at a cutoff-value of 1.9 with an AUC of 0.835.  CONCLUSIONS Volumetric analysis of ICH, IVH and intraventricular CSF may improve the prediction of CSF shunt implantation in patients with spontaneous ICH.

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Acute hydrocephalus and delayed cerebral infarction after aneurysmal subarachnoid hemorrhage

Cited by 7 publications

References 42 publications

Risk factors and predictive models of poor prognosis and delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage complicated with hydrocephalus

Risk factors and predictive models of poor prognosis and delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage complicated with hydrocephalus

The value of modified hijdra score in patients with aneurysmal subarachnoid hemorrhage

Predicting the need for a cerebrospinal fluid Shunt implantation after spontaneous Intracerebral Hemorrhage: A challenging task

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