Clinical neurology and neurosurgery · 2026
Spontaneous cerebellar hemorrhage: Risk factors associated with hydrocephalus and ventriculoperitoneal shunt dependency.
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Chen Chiu-Chun, Kao Ting-Hsien, Chen Jun-Peng, Shen Chiung-Chyi, Yang Meng-Yin, Lai Chih-Ming
Аннотация
OBJECTIVE: Hydrocephalus is a well-known complication of cerebellar hemorrhage (CH). However, data on risk factors for ventriculoperitoneal (VP) shunt dependency following CH remain limited. Therefore, this exploratory study aimed to analyze the potential risk factors for CH-related hydrocephalus and VP shunt dependency.
METHODS: In this retrospective study, we enrolled 82 patients with spontaneous CH admitted to Taichung Veterans General Hospital, Taiwan between January 2016 and June 2022. We compared baseline characteristics, clinical manifestations, neuroradiological features, and neurosurgical interventions between hydrocephalus and non-hydrocephalus groups; 63 patients were evaluated for VP shunt dependency.
RESULTS: In total, 51% of patients with CH developed hydrocephalus. The VP shunt dependency rate was 22.2% for all patients with CH and 60.9% for patients with hydrocephalus. Similar risk factors were observed for CH-related hydrocephalus and VP shunt dependency; these included intraventricular hemorrhage (IVH) on arrival, lower initial Glasgow Coma Scale (GCS), vermis distribution, peduncle distribution, basal cistern obliteration, grade three fourth ventricle compression, and hematoma volume. Receiver operating characteristic curves used to identify the relationship between VP shunt dependency, hematoma volume, and GCS revealed a preliminary cut-off value of 8.8 cm3 for hematoma volume and 12 for GCS.
CONCLUSIONS: Among patients with CH, 22.2% required VP shunts. Female sex, lower initial GCS (≤12), IVH and its locations (especially fourth ventricle), fourth ventricle compression, basal cistern obliteration, hematoma volume (cut-off value, 8.8 cm3), and vermis and peduncle distribution were identified as potential predictors of VP shunt dependency. However, further prospective studies are needed to validate these findings.
METHODS: In this retrospective study, we enrolled 82 patients with spontaneous CH admitted to Taichung Veterans General Hospital, Taiwan between January 2016 and June 2022. We compared baseline characteristics, clinical manifestations, neuroradiological features, and neurosurgical interventions between hydrocephalus and non-hydrocephalus groups; 63 patients were evaluated for VP shunt dependency.
RESULTS: In total, 51% of patients with CH developed hydrocephalus. The VP shunt dependency rate was 22.2% for all patients with CH and 60.9% for patients with hydrocephalus. Similar risk factors were observed for CH-related hydrocephalus and VP shunt dependency; these included intraventricular hemorrhage (IVH) on arrival, lower initial Glasgow Coma Scale (GCS), vermis distribution, peduncle distribution, basal cistern obliteration, grade three fourth ventricle compression, and hematoma volume. Receiver operating characteristic curves used to identify the relationship between VP shunt dependency, hematoma volume, and GCS revealed a preliminary cut-off value of 8.8 cm3 for hematoma volume and 12 for GCS.
CONCLUSIONS: Among patients with CH, 22.2% required VP shunts. Female sex, lower initial GCS (≤12), IVH and its locations (especially fourth ventricle), fourth ventricle compression, basal cistern obliteration, hematoma volume (cut-off value, 8.8 cm3), and vermis and peduncle distribution were identified as potential predictors of VP shunt dependency. However, further prospective studies are needed to validate these findings.