Abstract

Objective To explore the efficacy of early lamina terminalis fenestration in the treatment of acute hydrocephalus after aneurismal subarachnoid hemorrhage. Methods Ninety-eight patients of acute hydrocephalus after aneurismal subarachnoid hemorrhage who were treated by clipping were retrospectively analyzed. These cases were divided into two groups, including aneurysm clipping group alone (42 cases) and clipping with lamina terminalis fenestration group(56 cases). The improving rate of acute hydrocephalus and the incidence rate of shunt-dependent hydrocephalus after surgical treatment were compared between two groups. Results All surgical clipping procedures were performed within 72 hours after aneurysm rupture. Ultimately, 46 cases of acute hydrocephalus patients acquired improvement and 27 cases developed to chronic hydrocephalus after surgical treatment among 98 patients. Fourteen cases of acute hydrocephalus patients in aneurysm clipping group were improved (the improvement rate was 33.3%) and 14 cases developed into shunt-dependent hydrocephalus (the incidence rate was 33.3%). Thirty-two cases of acute hydrocephalus patients in lamina terminalis fenestration after aneurysm clipping group were improved (the improvement rate was 57.1%) and 13 cases developed into chronic hydrocephalus (the incidence rate was 23.2%). The acute hydrocephalus improvement rate and shunt-dependent hydrocephalus incidence rate in posterior circulation aneurysm group were statistically difference between aneurysm clipping group and lamina terminalis fenestration after aneurysm clipping group(P 0.05). Conclusions The efficacy of early lamina terminalis fenestration in the treatment of acute hydrocephalus after aneurismal subarachnoid hemorrhage was effective in posterior circulation aneurysm clipping. Key words: Intracranial aneurysm; Subarachnoid hemorrhage; Hydrocephalus; Comparative effectiveness research; Lamina terminalis fenestration

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