Hydrocephalus as a Complication of Subarachnoid Hemorrhage

Hydrocephalus is a relatively common complication of subarachnoid hemorrhage. Hydrocephalus is classified as acute, subacute or chronic according to the time elapsed from the onset of subarachnoid hemorrhage. Etiology involves either an obstruction of cerebrospinal fluid (CSF) flow or disturbed CSF resorption. Hydrocephalus in urgent situations is usually treated with temporary external ventricular or lumbar drainage. Chronic forms are managed with permanent shunting, usually a ventriculoperitoneal shunt. We performed a retrospective analysis of 350 patients admitted to our centre with the diagnosis of subarachnoid hemorrhage over a 10-year period, from 1999 to 2008. Hydrocephalus occurred in 13.4% of patients with subarachnoid hemorrhage. Hydrocephalus was more frequent in patients with the initial Fisher score three and more, with aneurysm managed with endovascular treatment and with a history of temporary cerebrospinal fluid drainage. The median time from an onset of subarachnoid hemorrhage to development of hydrocephalus was 20 days.