Évaluation des facteurs prédictifs d’évolution d’hydrocéphalie chronique au décours d’une hydrocéphalie aiguë après une hémorragie sous arachnoïdienne d’origine

Abstract : Background and objectives: the development of shunt dependent hydrocephalus is a well known complication after subarachnoid hemorrhage (SAH) and is linked to worse clinical outcomes. Acute hydrocephalus at the time of admission is an independent risk factor to develop shunt dependent hydrocephalus after SAH. The present study was designed to identify factors that could be associated with the need of permanent ventricular shunt placement after acute hydrocephalus in aneurysmal or sine materia SAH. Methods: between December 2015 and May 2018 we conduct a prospective observational study on a database collecting all patients admitted for SAH at Henri Mondor university teaching hospital. We included all patients presenting acute hydrocephalus at admission treated by an external ventricular drain (EVD) insertion after aneursymal or sine materia SAH. The primary endpoint was a permanent shunt requirement. Cox regression analysis was performed on clinical, biological and radiological variables. Results: 100 patients have been included in the analysis. 15% needed a permanent ventricular shunt placement. Univariate analysis found as risk factors, an EVD challenge failure (p=0,003), a third ventricle ≥ 8,8 mm (p = 0,01) and a bicaudate index ≥ 0,19 mm (p = 0,007) at the time of EVD challenge. Conclusion: EVD challenge failure, continued ventricular system expansion at the time of EVD challenge were predictive of shunt dependent hydrocephalus after acute hydrocephalus in aneurysmal or sine materia SAH.
Document type :
Master Thesis
Complete list of metadatas

Cited literature [39 references]  Display  Hide  Download

https://dumas.ccsd.cnrs.fr/dumas-02112340
Contributor : Université Paris Descartes - Scd <>
Submitted on : Friday, April 26, 2019 - 3:49:24 PM
Last modification on : Friday, May 10, 2019 - 10:08:09 AM

File

ThExe_ARNAUD_Mellissa_DUMAS.pd...
Files produced by the author(s)

Licence


Distributed under a Creative Commons Attribution - NonCommercial - NoDerivatives 4.0 International License

Identifiers

  • HAL Id : dumas-02112340, version 1

Citation

Mélissa Arnaud. Évaluation des facteurs prédictifs d’évolution d’hydrocéphalie chronique au décours d’une hydrocéphalie aiguë après une hémorragie sous arachnoïdienne d’origine. Médecine humaine et pathologie. 2018. ⟨dumas-02112340⟩

Share

Metrics

Record views

23

Files downloads

56