Reduced speech activity and hypokinetic phonation in communicating hydrocephalus following subarachnoid hemorrhage

1980 ◽  
Vol 224 (1) ◽  
pp. 25-32
Author(s):  
S. Gackenholz ◽  
D. Cramon
2010 ◽  
Vol 34 (8) ◽  
pp. S19-S19
Author(s):  
Tong Li ◽  
Peng Zhang ◽  
Bin Yuan ◽  
Dongliang Zhao ◽  
Yueqin Chen ◽  
...  

1999 ◽  
Vol 91 (1) ◽  
pp. 80-84 ◽  
Author(s):  
Eric M. Massicotte ◽  
Marc R. Del Bigio

Object. The origin of chronic communicating hydrocephalus following subarachnoid hemorrhage (SAH) is not well understood. Fibrosis of the arachnoid villi has been suggested as the cause for obstruction of cerebrospinal fluid (CSF) flow, but this is not well supported in the literature. The goal of this study was to determine the relationship between blood, inflammation, and cellular proliferation in arachnoid villi after SAH.Methods. Arachnoid villi from 50 adult patients were sampled at autopsy. All specimens were subjected to a variety of histochemical and immunohistochemical stains. The 23 cases of SAH consisted of patients in whom an autopsy was performed 12 hours to 34 years post-SAH. Fifteen cases were identified as moderate-to-severe SAH, with varying degrees of hydrocephalus. In comparison with 27 age-matched non-SAH controls, the authors observed blood and inflammation within the arachnoid villi during the 1st week after SAH. Greater mitotic activity was also noted among arachnoid cap cells. The patient with chronic SAH presented with ventriculomegaly 2 months post-SAH and exhibited remarkable arachnoid cap cell accumulation.Conclusions. The authors postulate that proliferation of arachnoidal cells, triggered by the inflammatory reaction or blood clotting products, could result in obstruction of CSF flow through arachnoid villi into the venous sinuses. This does not exclude the possibility that SAH causes generalized fibrosis in the subarachnoid space.


Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Yogesh Moradiya ◽  
Santosh Murthy ◽  
Christa San Luis ◽  
Daniel Hanley ◽  
Wendy Ziai

Background and Purpose: Aneurysmal subarachnoid hemorrhage (SAH) and spontaneous intracerebral hemorrhage (ICH) frequently lead to obstructive and/or communicating hydrocephalus. A permanent ventricular shunt is required in cases with failure to wean ventriculostomy. Large-scale studies comparing rates of ventricular shunting after SAH and ICH are lacking. Therefore, we studied the rates of shunting among SAH and ICH requiring ventriculostomy. Methods: We analyzed the Nationwide Inpatient Sample, a 20% sample of non-federal hospitalizations in US from 2002 to 2011 to select adults with ICH (ICD-9 code 431) and SAH (430) undergoing ventriculostomy (02.2, 02.21). We excluded patients surviving <7 days after ventriculostomy. We compared rates of ventricular shunting (02.32-02.34) between SAH and ICH after adjusting for baseline characteristics using logistic regression. Population estimates were obtained using sample weighting. Results: 23,541 cases with ICH (median age 59 y) and 31,883 cases with SAH (median age 56 y) were included. Unadjusted shunting rate was higher in SAH compared to ICH (19.9% vs 11.4%, P<0.001), and it remained higher in SAH in multivariate analysis (adjusted OR: 1.69; 95% CI: 1.45-1.98, P<0.001). There was no difference in the interval between ventriculostomy and shunting between SAH and ICH (mean: 18.9 +/- 11.8 [SD] vs 18.1 +/- 10.9 days, P=0.196). Among SAH cases, shunting rate was higher with coiling compared to clipping (23.8% vs 18.1%, P<0.001). There was a significant trend toward higher shunt utilization over time among SAH patients (16.3% in 2002-03 to 21.4% in 2010-11, trend P<0.001). The shunting rate remained unchanged among ICH patients (11.3% in 2002-03 to 11.5% in 2010-11, trend P=0.363). Patients requiring ventriculostomy within 24 hours of admission comprised 61.8% of all cases, and had higher shunting rate (adjusted OR: 1.17; 95% CI: 1.07-1.28, P=0.001). Conclusions: SAH compared to ICH has higher rates of failure to wean ventriculostomy requiring permanent ventricular shunting. Increasing trend in shunt utilization after SAH is co-incident with increase in aneurysm coiling during recent years.


Author(s):  
Jamie J. Van Gompel

Lumbar drainage has a major role in neurosurgical and neurocritical care procedures. Lumbar drain insertion is a simple and, when done well, low-risk procedure. A lumbar drain is often necessary in the management of perioperative cerebrospinal fluid (CSF) leaks, the most common use, but it may be beneficial for patients with subarachnoid hemorrhage and communicating hydrocephalus and for patients undergoing surgery involving the aorta with possible damage to the spinal cord. CSF removal optimizes spinal cord blood flow. This chapter describes lumbar drain insertion and some of the associated perils and pitfalls.


1979 ◽  
Vol 51 (3) ◽  
pp. 341-351 ◽  
Author(s):  
John Vassilouthis ◽  
Alan E. Richardson

✓ Ventricular dilatation following spontaneous subarachnoid hemorrhage (SAH) is a well recognized phenomenon. Its clinical significance, however, remains controversial. Two phases are distinguished, the acute or early, occurring soon after the ictus, and the chronic or late, developing after the second week. The authors studied the ventricular size in 210 patients with spontaneous SAH through the course of their illness and convalescence by means of serial computerized tomography (CT) scans. Their findings suggest that ventricular dilatation soon after SAH is not always clinically significant and does not necessarily require shunting before definitive surgery. Delayed symptomatic ventricular enlargement (communicating hydrocephalus) occurs in 7% of the patients and can be safely diagnosed on the basis of the clinical picture and CT scan appearances. Treatment with a ventricular shunting system is almost invariably rewarding.


1973 ◽  
Vol 39 (4) ◽  
pp. 474-479 ◽  
Author(s):  
M. Gazi Yasargil ◽  
Yasuhiro Yonekawa ◽  
Bruno Zumstein ◽  
Hans-Jürgen Stahl

✓ Twenty-eight cases of communicating hydrocephalus after subarachnoid hemorrhage (SAH) due to ruptured intracranial aneurysms are reported. The relationship between the incidence of this complication and the various clinical features of SAH is discussed. The findings of RISA cisternography have little relationship to the findings of pneumoencephalography or the results of shunting procedures. The availability and value of echoencephalography in treating such patients is emphasized.


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