Chang et al reported risk factors for shunt dependence after aneurysmal subarachnoid hemorrhage (aSAH). These can help to identify a patient who may benefit from more aggressive management. The authors are from the National Yang-Ming University in Taipei, Taiwan.

Patient selection: aneurysmal subarachnoid hemorrhage


Outcome: shunt-dependent hydrocephalus


Predictors of shunt-dependence:

(1) poor Hunt & Hess grade (III, IV or V)

(2) initial placement of an external ventriculostomy

(3) leukocytosis in the Emergency Department (WBC count > 14,500 per microliter


Early placement of a ventricular-peritoneal shunt after aSAH was associated with a shorter stay in the ICU and in the hospital.

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