Cerebral Aneurysms Management Following Sah

HYDROCEPHALUS

Hydrocephalus causing acute deterioration in conscious level requires urgent CSF drainage with a ventricular catheter (in 'communicating' hydrocephalus lumbar puncture may provide temporary benefit).

Gradual deterioration or failure to improve in the presence of enlarged ventricles indicates the need for permanent CSF drainage with either a ventriculoperitoneal or lumboperitoneal shunt.

EXPANDING INTRACEREBRAL HAEMATOMA

Intracerebral haematomas from ruptured aneurysms do not require specific treatment unless the 'mass' effect causes a deterioration of conscious level. This necessitates urgent angiography followed by evacuation of the haematoma with or without simultaneous clipping of the aneurysm; under these circumstances, operative mortality is high.

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