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Medicina clínica y social

versão On-line ISSN 2521-2281

Resumo

DIAZ, Dario et al. Factors associated with the development of peritoneal ventricular shunt-dependent hydrocephalus in patients operated on for cerebral aneurysms. Med. clín. soc. [online]. 2020, vol.4, n.2, pp.75-80. ISSN 2521-2281.  https://doi.org/10.52379/mcs.v4i2.118.

Introduction:

Various factors may be associated with the development of hydrocephalus in patients operated on for cerebral aneurysms that are later dependent on peritoneal ventricular shunt, may be due to mechanical or inflammatory obstruction with decreased absorption of cerebrospinal fluid (CSF).

Objective:

To determine factors associated with the development of peritoneal ventricular shunt-dependent hydrocephalus in patients with cerebral aneurysms who have received surgical treatment for clipping.

Methods:

Observational, descriptive, retrospective cross-sectional study of clinical records of 171 patients operated on for cerebral aneurysms at the Hospital de Clínicas from 2013 to February 2020.

Results:

171 cases operated on for cerebral aneurysms have been analyzed, most of the female sex (71%), with an age range of 17-77 years (median 53 years). 7.6 % developed hydrocephalus with a peritoneal ventricle shunt requirement. Of these patients, 61.5% had a history of decompressive craniectomy (p <0.001). 84.6% presented both clinical and radiological vasospasm (p <0.001). The most frequent locations were in the internal carotid and middle cerebral arteries with 38.9% for both. The Fisher IV scale was the most frequent with 76.9%, then Fisher II with 15.3% (p = 0.14). 62.2% underwent surgery during the acute phase (p = 0.03).

Conclusion:

Factors with a statistically significant association with the development of hydrocephalus have been observed in this study, such as the presence of vasospasm and those undergoing decompressive craniectomy, which are in accordance with the literature, unlike what occurs with the phase of the disease in the that surgery was performed, which in our study showed a predominance in the acute phase, in contrast to what is observed in various bibliographic sources.

Palavras-chave : Cerebral aneurysm; hydrocephalus; peritoneal ventricle shunt; associated factors..

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