Hydrocephalus after aneurysmal subarachnoid hemorrhage treatment [Neurosurgery Wiki]

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====== Hydrocephalus after aneurysmal subarachnoid hemorrhage treatment ======

{{rss>https://pubmed.ncbi.nlm.nih.gov/rss/search/10WuL-PqA2A7CL1VA9WTFaQ0MvC5T_AHIWR5vnidrCmDcNsQSs/?limit=15&utm_campaign=pubmed-2&fc=20250206055546}}

Potential medicines for [[Hydrocephalus after aneurysmal subarachnoid hemorrhage]] are still in preclinical status, and surgery is the most prevalent and efficient therapy, despite respective risks of different surgical methods, including lamina terminalis fenestration, ventricle-peritoneal shunting, and lumbar-peritoneal shunting. HCP remains an ailment that cannot be ignored and even with various solutions the medical community is still trying to understand and settle why and how it develops and accordingly improve the prognosis of these patients with HCP
((Chen S, Luo J, Reis C, Manaenko A, Zhang J. Hydrocephalus after Subarachnoid Hemorrhage: Pathophysiology, Diagnosis, and Treatment. Biomed Res Int. 2017;2017:8584753. doi: 10.1155/2017/8584753. Epub 2017 Mar 8. PMID: 28373987; PMCID: PMC5360938.))
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===== Management Strategies =====

### **1. Acute Management**
- **External Ventricular Drainage (EVD)**:
  - Indicated in **symptomatic hydrocephalus**.
  - Allows CSF diversion and intracranial pressure (ICP) monitoring.
  - Risk: **Infections (ventriculitis), overdrainage leading to subdural hematomas**.

- **Serial Lumbar Punctures or Lumbar Drainage**:
  - Used if **communicating hydrocephalus** is suspected.
  - Helps determine if a **shunt will be needed**.

### **2. Long-Term Management**
- **Ventriculoperitoneal (VP) or Ventriculoatrial (VA) Shunting**:
  - Indicated in **chronic or persistent hydrocephalus**.
  - Programmable valves reduce complications related to **overdrainage (e.g., subdural hematomas)**.

- **Endoscopic Third Ventriculostomy (ETV)**:
  - Considered in **non-communicating hydrocephalus**.
  - Less commonly used in post-aSAH hydrocephalus due to arachnoid granulation dysfunction.

====== External ventricular drain for hydrocephalus after aneurysmal subarachnoid hemorrhage ======
[[External ventricular drain for hydrocephalus after aneurysmal subarachnoid hemorrhage]].

====== Ventriculoperitoneal shunt for hydrocephalus after aneurysmal subarachnoid hemorrhage ======
[[Ventriculoperitoneal shunt for hydrocephalus after aneurysmal subarachnoid hemorrhage]].

===== Endoscopic third ventriculostomy for hydrocephalus after aneurysmal subarachnoid hemorrhage =====

[[Endoscopic third ventriculostomy for hydrocephalus after aneurysmal subarachnoid hemorrhage]]