Journal of Korean Neurosurgical Society

  • 제48권4호
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  • Pages.313-318
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  • 2010
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Risk of Shunt Dependent Hydrocephalus after Treatment of Ruptured Intracranial Aneurysms : Surgical Clipping versus Endovascular Coiling According to Fisher Grading System

  • Nam, Kyung-Hun (Department of Neurosurgery, Kyungpook National University Hospital) ;
  • Hamm, In-Suk (Department of Neurosurgery, Kyungpook National University Hospital) ;
  • Kang, Dong-Hun (Department of Neurosurgery, Kyungpook National University Hospital) ;
  • Park, Jae-Chan (Department of Neurosurgery, Kyungpook National University Hospital) ;
  • Kim, Yong-Sun (Department of Neuroradiology, Kyungpook National University Hospital)
  • 투고 : 2010.01.08
  • 심사 : 2010.09.27
  • 발행 : 2010.10.28
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초록

Objective : The amount of hemorrhage observed on a brain computed tomography scan, or a patient's Fisher grade (FG), is a powerful risk factor for development of shunt dependent hydrocephlaus (SDHC). However, the influence of treatment modality (clipping versus coiling) on the rate of SDHC development has not been thoroughly investigated. Therefore, we compared the risk of SDHC in both treatment groups according to the amount of subarachnoid hemorrhage (SAH). Methods : We retrospectively reviewed 839 patients with aneurysmal SAH for a 5-year-period. Incidence of chronic SDHC was analyzed using each treatment modality according to the FG system. In addition, other well known risk factors for SDHC were also evaluated. Results : According to our data, Hunt-Hess grade, FG, acute hydrocephalus, and intraventricular hemorrhage were significant risk factors for development of chronic SDHC. Coiling group showed lower incidence of SDHC in FG 2 patients, and clipping groups revealed a significantly lower rate in FG 4 patients. Conclusion : Based on our data, treatment modality might have an influence on the incidence of SDHC. In FG 4 patients, the clipping group showed lower incidence of SDHC, and the coiling group showed lower incidence in FG 2 patients. We suggest that these findings could be a considerable factor when deciding on a treatment modality for aneurysmal SAH patients, particularly when the ruptured aneurysm can be occluded by either clipping or coiling.

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참고문헌

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  18. Clipping versus Coiling in Ruptured Aneurysms of the Anterior Cerebral Circulation vol.10, pp.1, 2020, https://doi.org/10.4236/ojmn.2020.101010
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