ECHO-ENCEPHALOGRAPHIC STUDY of VENTRICULAR DILATATION AFTER SUBARACHNOID HEMORRHAGE, WITH SPECIAL REFERENCE to the EFFECT of ANTIFIBRINOLYTIC TREATMENT

Abstract

Echo-encephalographic examinations were performed in 144 patients after subarachnoid hemorrhage. Antifibrinolytic treatment (trans-4-aminomethylcyclohexanecarboxylic acid, AMCA) was given to 93 patients. The width of the 3rd ventricle was measured in all the patients and lateral ventricle measurements were obtained in 94 patients. Third ventricular dilatation developed in 78 patients (54%) and lateral ventricle enlargement was seen in 55 patients (58% of those examined). The incidence of 3rd ventricle dilatation was higher in the AMCA-treated group (62.5%) than in the non-treated group (39.2%) and this difference was statistically significant (P < 0.05). The hydrocephalus in most cases developed 2-3 wk after the bleeding, and reached its peak within the first 2-3 mo., with subsequent complete or partial normalization of the ventricular size. At later follow-up examinations 1-4 yr after the bleeding, only 9 patients had persisting dilatation of moderate or pronounced degree. There was no indication that the dilatation was more severe or protracted in the AMCA-treated group than in the non-treated group. In 11 patients the hydrocephalus required a shunt operation, but the frequency of shunt operations was not significantly different in the 2 groups. Although AMCA-treated patients in comparison with non-treated patients may be exposed to a somewhat higher risk of complicating hydrocephalus after subarachnoid hemorrhage, this risk cannot at present be considered as any serious contraindication to this sort of treatment.