Clinical fellow (Neurosurgery) Royal Preston Hospital
Introduction: To determine predictive factors of intraventricular haemorrhage / SAH leading to secondary hydrocephalus requiring permanent CSF diversion
Methods: we conducted a retrospective review of ten years from 2011-2020 of patients with non aneurysmal spontaneous SAH with IVH. Our outcomes of interest were age ,gender ,GCS on admission and primary discharge ,Anticoagulant use, Intervention offered, Associated ICH requiring surgery, Location of bleed, EVD placement, Length of ITU / hospital stay and Interval from primary event to VP shunting. Analysis was done using SPSS 26.0.1
Results: we reviewed 149 patient out of which patient undergone CSF permanent diversion were 13 (8.72%). The mean age of the patients was 53.36 years. The median GCS at presentation was 7 while median GCS at discharge was 11. Majority of the patient had a supratentorial bleed. Around 7 patients undergoing CSF shunting had >1 EVD inserted prior to diversion while 4 patient had a single EVD placed prior to shunting. The mean length of ICU stay was 21.08 days and mean Hospital stay 91.07 days. The mean interval for temporary to permanent CSF diversion was 65.84 days.
Conclusion : our study showed a highly likelihood of need for permanent CSF diversion if >1 EVD / temporary diversion was done for the patient. Early CSF shunting in such patients can help decrease hospital stay and also reduce the risk of emergency admission due to acutely worsened neurology and can be potentially life saving
