Predictors of Shunt-dependent Hydrocephalus After Aneurysmal Subarachnoid Hemorrhage? A Systematic Review and Meta-Analysis

Xie, Zhiyi; Hu, Xiuying; Zan, Xin; Su, Lin; Li, Hao; You, Chao

doi:10.1016/j.wneu.2017.06.119

Cited by 85 publications

(67 citation statements)

References 45 publications

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“…In the case of a strong cli-nical suspicion of HSA, despite imaging exams, such as CT and/ or Resonance of the negative encephalic brain (MRI), lumbar puncture is the next diagnostic step (Yao et al, 2017, Stehouwer et al, 2018. The distinction between cerebrospinal fluid (CSF) due to HSA or puncture accident with the needle may be severe, however, the persistence of elevated erythrocytes count in consecutive collection tubes (CSF remains well bleeding throughout the collection) and immediate centrifugation of the CSF with the presence of xanthochromia (rose/ yellow supernatant resulting from the degradation of hemoglobin, indicates the blood present in the CSF there are at least 2h) classic HSA findings (Xie et al, 2017).…”

Section: Complementary Examsmentioning

confidence: 99%

“…Airway stabilization, respiration, and circulation (ABC) are essential, and the need for orotracheal intubation should be evaluated (Lawton & Vates, 2017, Xie et al, 2017, Zhou et al, 2017.…”

Section: Treatmentmentioning

confidence: 99%

“…Hyponatremia should be treated with isotonic saline or hypertonic saline solution, if severe natriuresis -Na+<133 mEq/L or reduction of 6mEq/L in 48h (Steiner et al, 2013, Vivancos et al, 2014, Xie et al, 2017.…”

Section: Hyponatremiamentioning

confidence: 99%

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Spontaneous Subarachnoid Hemorrhage: updated clinical and therapeutic approach

Pinheiro¹,

Ernesto²,

Rêgo³

et al. 2019

JPCBS

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Despite advances in the treatment of subarachnoid hemorrhage, morbimortality rates remain elevated. Patients who have a sudden onset headache followed or not by altered consciousness, require a high degree of suspicion for the appropriate diagnosis in the emergency room. Those with lighter symptoms, presence of headache without other neurological alterations are the most susceptible to diagnostic error. All should be evaluated quickly, receiving specialized neurointensive care and ear

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Section: Complementary Examsmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

See 1 more Smart Citation

Spontaneous Subarachnoid Hemorrhage: updated clinical and therapeutic approach

Pinheiro¹,

Ernesto²,

Rêgo³

et al. 2019

JPCBS

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“…The incidence of hydrocephalus in SAH patients is as high as 6-67%, depending on specific background and clinical circumstances [1,12], but most recent studies report an overall 20-30% incidence of hydrocephalus after SAH [9,17]. The onset of hydrocephalus can be acute (within 48 h after SAH) or, more rarely, chronic (weeks and even months after the haemorrhage) [22,46,48]. Regardless of its timing, hydrocephalus significantly impairs the patient's central nervous system and leads to functional deterio-ration, especially with intraventricular haemorrhage [9].…”

Section: Introductionmentioning

confidence: 99%

The dynamic expression of aquaporins 1 and 4 in rats with hydrocephalus induced by subarachnoid haemorrhage

Long¹,

Huang²,

Du³

et al. 2019

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Introduction: Hydrocephalus is a common complication of subarachnoid haemorrhage (SAH). As transmembrane water channels, aquaporins 1 and 4 (AQP1 and AQP4) are involved in the pathogenesis of hydrocephalus. We aimed to assess the association between the expressions of AQP1 and AQP4 and the severity and duration of hydrocephalus after SAH. Material and methods: A double haemorrhage model by injection of autologous blood into the cisterna magna was used to induce SAH in rats. Sham rats received the same procedures, but with the injection of normal saline. The SAH group was divided into the SAH with hydrocephalus group and SAH without hydrocephalus group after identifying hydrocephalus histologically. AQP1 and AQP4 in ventricle regions were detected by immunofluorescence, quantitative polymerase chain reaction (qPCR) and western blot. Results: Hydrocephalus was the most severe at day 3 after SAH. AQP1 and AQP4 mRNA and protein levels increased at day 1 and peaked at day 3. The SAH with hydrocephalus group had a higher expression of AQP1 and AQP4 than the SAH without hydrocephalus group. Higher AQP1 levels were found at the apical and basolateral membrane of the choroid plexus epithelium, while higher AQP4 levels were found in the ependymal cells. A positive correlation between the relative lateral ventricle area and the ratio of AQP1/AQP4 proteins was identified. Conclusions: AQP1 and AQP4 are remarkably correlated with the severity of hydrocephalus induced by SAH. AQP1 and AQP4 are potential drug targets for developing therapeutic strategies against hydrocephalus.

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“…In a meta-analysis of 25 studies, risk factors of SDH after SAH include increased age (≥50), female gender, high Hunt-Hess grades, low Glasgow Coma Scale scores (≤8), high Fisher grades (≥3), acute hydrocephalus, external ventricular drainage (EVD) insertion, intraventricular hemorrhage (IVH), posterior circulation aneurysm, anterior communicating artery aneurysm, clinical vasospasm, meningitis, and rebleeding 26) . Treatments for SDH after SAH include medications (such as acetazolamide and mannitol) and surgical treatments (such as lamina terminalis fenestration, VPS, and lumbar-peritoneal shunting)…”

Section: Introductionmentioning

confidence: 99%

Effect of Lumbar Drainage on Incidence of Shunt-Dependent Hydrocephalus in Patients with Subarachnoid Hemorrhage Due to Ruptured Aneurysm Who Underwent Coil Embolization

Yim

Chung

et al. 2018

Nerve

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Chronic or shunt-dependent hydrocephalus (SDH) is a hydrocephalus that develops at two weeks or more after onset of subarachnoid hemorrhage (SAH). A recent study has reported that lumbar drainage (LD) can reduce the incidence of SDH after coil embolization of aneurysmal SAH, different from previous studies. The purpose of this study was to determine the effect of LD on incidence of SDH after SAH in patients who underwent coil embolization. Methods: A total of 113 patients who were treated with coil embolization only for SAH from January 2006 to August 2013 were investigated. They were randomly allocated into two groups depending on the management protocol that included LD insertion or not. SDH was defined based on Evans index and bicaudate index on computed tomography. We compared incidence of SDH according to the presence and absence of LD. Results: LD was performed in 53 (46.9%) patients. Of these patients, 14 had SDH measured by Evans index (p=0.089) while seven had SDH measured by bicaudate index (p=0.007). Ventriculoperitoneal shunt was performed in five patients of LD group (p=0.258). Conclusion: LD insertion in patients who underwent coil embolization reduced the risk of SDH after SAH.

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Predictors of Shunt-dependent Hydrocephalus After Aneurysmal Subarachnoid Hemorrhage? A Systematic Review and Meta-Analysis

Cited by 85 publications

References 45 publications

Spontaneous Subarachnoid Hemorrhage: updated clinical and therapeutic approach

Spontaneous Subarachnoid Hemorrhage: updated clinical and therapeutic approach

The dynamic expression of aquaporins 1 and 4 in rats with hydrocephalus induced by subarachnoid haemorrhage

Effect of Lumbar Drainage on Incidence of Shunt-Dependent Hydrocephalus in Patients with Subarachnoid Hemorrhage Due to Ruptured Aneurysm Who Underwent Coil Embolization

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