Hydrocephalus in the Adult Secondary to the Rupture of Intracranial Arterial Aneurysms

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The interest paid during the last years to the hydrocephalic syndrome in the adult is reflected in the increasing number of publications dealing with this subject.1,2,8,11,14,16,17,20,25,27,31 The nomenclature is somewhat confusing, for terms such as “occult hydrocephalus,” “non-pressure hydrocephalus,” “normal-pressure hydrocephalus,” “low-pressure hydrocephalus,” “idiopathic hydrocephalus,” and “nonobstructive adult hydrocephalus” have been used to refer, within some limitations, to the same clinical entity. Some new etiological aspects have been reported,8,11 and more active therapy is being carried out in most neurological centers.

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Figures

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    Carotid angiography, venous phase, showing three different stages of ventricular dilatation in three patients. Left: Normal. Center: Mild dilatation. Right: Severe dilatation and hydrocephalus.

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    Graph plotting the ventriculocranial index of patients in whom a dilatation of the ventricular system was disclosed. Index changes more than 0.025 = 2 mm. The broken lines connect the index figures obtained in different ipsilateral angiograms on the same patient. Values above the full line (index 0.33) are considered as radiological evidence of hydrocephalus.

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    Graph showing the ventriculocranial index of patients in whom no dilatation of the ventricular system was disclosed. Index changes less than 0.025 = 2 mm.

  • View in gallery

    Graph demonstrating the correlation between the size of the ventricles (expressed in terms of the ventriculocranial index) and the cerebral circulation time (expressed in seconds). The dotted lines indicate upper normal values. (Normal circulation time = 3.5 ± SD 0.5.)

References

1.

AdamsR. D.FischerC. M.HakimS.OjemannR. G. and SweetH. H. Symptomatic occult hydrocephalus with “normal” cerebro-spinal fluid pressure. A treatable syndrome. New Eng. J. Med.1965273:117126.Adams R. D. Fischer C. M. Hakim S. Ojemann R. G. and Sweet H. H. Symptomatic occult hydrocephalus with “normal” cerebro-spinal fluid pressure. A treatable syndrome. New Eng. J. Med. 1965 273:117–126.

2.

AdamsR. D. Further observations on normal pressure hydrocephalus. Proc. R. Soc. Med.1966592:11351140.Adams R. D. Further observations on normal pressure hydrocephalus. Proc. R. Soc. Med. 1966 592:1135–1140.

3.

AskenazyH. M.HerzbergerE. E. and WijsenbeckH. S. Hydrocephalus with vascular malformations of the brain. A preliminary report. Neurology Minneap.19533:213220.Askenazy H. M. Herzberger E. E. and Wijsenbeck H. S. Hydrocephalus with vascular malformations of the brain. A preliminary report. Neurology Minneap. 1953 3:213–220.

4.

BagleyC.Jr. Blood in the cerebrospinal fluid. Resultant functional and organic alterations in the central nervous system. A: Experimental data. Archs Surg. Chicago192817:1838.Bagley C. Jr. Blood in the cerebrospinal fluid. Resultant functional and organic alterations in the central nervous system. A: Experimental data. Archs Surg. Chicago 1928 17:18–38.

5.

BagleyC.Jr. Blood in the cerebrospinal fluid. Resultant functional and organic alterations in the central nervous system. B: Clinical data. Archs Surg. Chicago192817:3981.Bagley C. Jr. Blood in the cerebrospinal fluid. Resultant functional and organic alterations in the central nervous system. B: Clinical data. Archs Surg. Chicago 1928 17:39–81.

6.

BaileyO. T. and WoodardJ. S. Small vascular malformations of the brain: their relationship to unexpected death, hydrocephalus and mental deficiency. J. Neuropath. exp. Neurol.195918:98113.Bailey O. T. and Woodard J. S. Small vascular malformations of the brain: their relationship to unexpected death hydrocephalus and mental deficiency. J. Neuropath. exp. Neurol. 1959 18:98–113.

7.

BergvallU. and GaleraR. Time relationship between subarachnoid haemorrhage arterial spasm changes in cerebral circulation and post-haemorrhagic hydrocephalus. Presented at the VIIIe Symposium International Neuroradiologicum. ParisSept. 1967.Bergvall U. and Galera R. Time relationship between subarachnoid haemorrhage arterial spasm changes in cerebral circulation and post-haemorrhagic hydrocephalus. Presented at the VIIIe Symposium International Neuroradiologicum. Paris Sept. 1967.

8.

BreigA.EkbomK.GreitzT. and KugelbergE. Hydrocephalus due to the elongated basilar artery. A new clinicoradiological syndrome. Lancet19671:874875.Breig A. Ekbom K. Greitz T. and Kugelberg E. Hydrocephalus due to the elongated basilar artery. A new clinicoradiological syndrome. Lancet 1967 1:874–875.

9.

CateJ. T. Effets d'une anoxie ischemique prolongée sur le cerveau d'un chat, suivie d'une hydrocéphalie des ventricules latéraux. Arch. Int. Physiol.196270:4966.Cate J. T. Effets d'une anoxie ischemique prolongée sur le cerveau d'un chat suivie d'une hydrocéphalie des ventricules latéraux. Arch. Int. Physiol. 1962 70:49–66.

10.

CronquistS. Encephalographic changes following subarachnoid haemorrhage. Br. J. Radiol.196740:3842.Cronquist S. Encephalographic changes following subarachnoid haemorrhage. Br. J. Radiol. 1967 40:38–42.

11.

EkbomK.GreitzT. and KugelbergE. Hydrocephalus due to ectasia of the basilar artery. J. Neurol. Sci.19698:465.Ekbom K. Greitz T. and Kugelberg E. Hydrocephalus due to ectasia of the basilar artery. J. Neurol. Sci. 1969 8:465.

12.

FoltzE. L. and WardA. A. Communicating hydrocephalus from subarachnoid bleeding. J. Neurosurg.195613:546566.Foltz E. L. and Ward A. A. Communicating hydrocephalus from subarachnoid bleeding. J. Neurosurg. 1956 13:546–566.

13.

GreitzT. A radiologic study of the brain circulation by rapid serial angiography of the carotid artery. Acta radiol.1956 (Suppl. 140.) 123 pp. (See pp. 70123.)Greitz T. A radiologic study of the brain circulation by rapid serial angiography of the carotid artery. Acta radiol. 1956 (Suppl. 140.) 123 pp. (See pp. 70–123.)

14.

GreitzT. Cerebral blood flow in occult hydrocephalus studied with angiography and the 133Xenon clearance method. Acta radiol.19698:376384.Greitz T. Cerebral blood flow in occult hydrocephalus studied with angiography and the 133Xenon clearance method. Acta radiol. 1969 8:376–384.

15.

GreitzT.LevanderB. and LopezJ. High blood pressure and epilepsy in hydrocephalus. A study of 124 cases of aqueduct stenosis. (To be published in Acta neurochir.)Greitz T. Levander B. and Lopez J. High blood pressure and epilepsy in hydrocephalus. A study of 124 cases of aqueduct stenosis. (To be published in Acta neurochir.)

16.

HakimS. and AdamsK. D. The special clinical problem of symptomatic hydrocephalus with normal cerebrospinal pressure: observations on cerebrospinal fluid hydrodynamics. J. Neurol. Sci.19652:307327.Hakim S. and Adams K. D. The special clinical problem of symptomatic hydrocephalus with normal cerebrospinal pressure: observations on cerebrospinal fluid hydrodynamics. J. Neurol. Sci. 1965 2:307–327.

17.

HoganP. A. and WoolseyR. M. Hydrocephalus in the adult. J. Am. Med. Ass.1966198:524528.Hogan P. A. and Woolsey R. M. Hydrocephalus in the adult. J. Am. Med. Ass. 1966 198:524–528.

18.

JacksonI. J. Aseptic hemogenic meningitis. Arch. Neurol. Psychiat. Chicago194962:572589.Jackson I. J. Aseptic hemogenic meningitis. Arch. Neurol. Psychiat. Chicago 1949 62: 572–589.

19.

JohansonC. The central veins and deep dural sinuses of the brain. An anatomical and angiographic study. Acta radiol.1954 (Suppl. 107): 1184.Johanson C. The central veins and deep dural sinuses of the brain. An anatomical and angiographic study. Acta radiol. 1954 (Suppl. 107):1–184.

20.

KiblerR. F.CouchR. S. C. and CromptomM. R. Hydrocephalus in the adult following spontaneous subarachnoid haemorrhage. Brain196184:4561.Kibler R. F. Couch R. S. C. and Cromptom M. R. Hydrocephalus in the adult following spontaneous subarachnoid haemorrhage. Brain 1961 84:45–61.

21.

KrayenbühlH. and LuthyF. Hydrocephalus als Spätfolge geplatzer basaler Hirnaneurysmen. Schweitzer Arch. Neurol. Psychiat.194861:721.Krayenbühl H. and Luthy F. Hydrocephalus als Spätfolge geplatzer basaler Hirnaneurysmen. Schweitzer Arch. Neurol. Psychiat. 1948 61:7–21.

22.

KågströmE.GreitzT.HansonJ. and GaleraR. Changes in cerebral blood flow after subarachnoid haemorrhage. Proceedings of the IIIrd International Congress of Neurological Surgery, 1965. Excerpt. Med. Int. Congress SeriesNo. 1101966 pp. 629633.Kågström E. Greitz T. Hanson J. and Galera R. Changes in cerebral blood flow after subarachnoid haemorrhage. Proceedings of the IIIrd International Congress of Neurological Surgery 1965. Excerpt. Med. Int. Congress Series No. 110 1966 pp. 629–633.

23.

LindgrenE. Encephalography in cerebral atrophy. Acta radiol.195135:277291.Lindgren E. Encephalography in cerebral atrophy. Acta radiol. 1951 35:277–291.

24.

MatsubaraT. and NomuraT. A sign of cerebral venrricular dilatation observed in carotid phlebograms. Am. J. Roentg.196084:9395.Matsubara T. and Nomura T. A sign of cerebral venrricular dilatation observed in carotid phlebograms. Am. J. Roentg. 1960 84:93–95.

25.

McHughP. R. Occult hydrocephalus. Q. J. Med.196433:297312.McHugh P. R. Occult hydrocephalus. Q. J. Med. 1964 33:297–312.

26.

MerwarthH. R. and FreimanJ. S. Hydrocephalus following subarachnoid haemorrhage: report of a case with pathologic study. Brooklyn Hosp. J.19391:149157.Merwarth H. R. and Freiman J. S. Hydrocephalus following subarachnoid haemorrhage: report of a case with pathologic study. Brooklyn Hosp. J. 1939 1:149–157.

27.

MessertB. and BakerN. H. Syndrome of progressive spastic ataxia and apraxia associated with occult hydrocephalus. Neurology Minneap.196616:440452.Messert B. and Baker N. H. Syndrome of progressive spastic ataxia and apraxia associated with occult hydrocephalus. Neurology Minneap. 1966 16:440–452.

28.

PenfieldW. and ElvidgeA. R. Hydrocephalus and atrophy of cerebral compression. In: Cytology and cellular pathology of the nervous system. PenfieldW. Ed. N.Y.: P. B. Hoeber, Inc.19323:12011227.Penfield W. and Elvidge A. R. Hydrocephalus and atrophy of cerebral compression. In: Cytology and cellular pathology of the nervous system. Penfield W. Ed. N.Y.: P. B. Hoeber Inc. 1932 3:1201–1227.

29.

SchwartzP. Birth injuries of the newborn. New York: Hafner Publishing Co., Inc.1961384 pp. (See pp. 6773.)Schwartz P. Birth injuries of the newborn. New York: Hafner Publishing Co. Inc. 1961 384 pp. (See pp. 67–73.)

30.

ShulmanK.MartinB. F.PopoffN. and RansohoffJ. Recognition and treatment of hydrocephalus following spontaneous subarachnoid haemorrhage. J. Neurosurg.196320:10401047.Shulman K. Martin B. F. Popoff N. and Ransohoff J. Recognition and treatment of hydrocephalus following spontaneous subarachnoid haemorrhage. J. Neurosurg. 1963 20:1040–1047.

31.

TaptasJ. N. and KordiolisN. J. Les hydrocéphalies communicantes de l'adulte. Neuro-Chirurgie196814:717738.Taptas J. N. and Kordiolis N. J. Les hydrocéphalies communicantes de l'adulte. Neuro-Chirurgie 1968 14:717–738.

32.

WolfB. S. and HuangY. P. The subependymal veins of the lateral ventricles. Am. J. Roentgenol.196491:406426.Wolf B. S. and Huang Y. P. The subependymal veins of the lateral ventricles. Am. J. Roentgenol. 1964 91:406–426.

33.

YakovlevP. I. Paraplegias of hydrocephalics. Am. J. ment. Defic.194751:561576.Yakovlev P. I. Paraplegias of hydrocephalics. Am. J. ment. Defic. 1947 51:561–576.

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