Development of obstructive hydrocephalus with lumboperitoneal shunting following subarachnoid hemorrhage

Hydrocephalus is a frequent complication of subarachnoid hemorrhage (SAH). The optimum method of treating hydrocephalus in this setting has not been d etermined. We review our experience with patients developing communicating hydrocephalus secondary to SAH and subsequently treated with lumboperitonea l (LP) shunts. Following hospitalization for the treatment of SAH, patients who developed clinical symptoms and radiologic signs of hydrocephalus were treated with (ventriculoperitoneal) VP or LP shunting. Eighteen patients r eceived an LP shunt, of which seven (28%) developed a non-communicating or obstructive hydrocephalus. These seven patients underwent replacement with a VP shunt and have not had further complications. In the setting of post-S AM communicating hydrocephalus, obstructive hydrocephalus may develop after LP shunt placement. Patients who develop this complication and have their LP shunts converted to VP shunts have a favorable prognosis. (C) 1999 Elsev ier Science B.V. All rights reserved.