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Hydrocephalus after aneurysmal subarachnoid hemorrhage: Epidemiology, Pathogenesis, Diagnosis, and Management

  • Yu-Chang Wang1,2,3,†
  • Xiao-Qiang Wang4,†
  • Chang-Wu Tan1,2,3
  • Chuan-Sen Wang1,2,3
  • Zhi Tang5
  • Zhi-Ping Zhang1,2,3
  • Jing-Ping Liu1,2,3
  • Ge-Lei Xiao1,2,3

1Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P. R. China

2Diagnosis and Treatment Center for Hydrocephalus, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P. R. China

3National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P. R. China

4Pediatric neurological disease center, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200092, P. R. China

5Department of Neurosurgery, Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan 410013, P. R. China

DOI: 10.22514/sv.2021.021 Vol.17,Issue 4,July 2021 pp.4-17

Submitted: 02 January 2021 Accepted: 26 January 2021

Published: 08 July 2021

*Corresponding Author(s): Ge-Lei Xiao E-mail:

† These authors contributed equally.


Hydrocephalus is one of the most common complications of aneurysmal subarachnoid hemorrhage (aSAH), which seriously affects the quality of life and shortens the survival time of affected patients. By reviewing the recent studies on the risk factors of aSAH-associated hydrocephalus, we aimed to explicitly present the pathogenesis of acute and chronic hydrocephalus after aSAH and make a comprehensive list of the associated risk factors of aSAH-associated hydrocephalus and shunt-dependent hydrocephalus. It would help us to better explain the occurrence of hydrocephalus after aSAH, especially hydrocephalus caused by inflammation after bleeding. Many studies have recently suggested that high mobility group box 1 may be an early upstream promoter of inflammatory response after aSAH, which also provides important ideas for us to look for potential drug treatments. The surgery, such as external ventricular drain and lumbar drainage, is the most common and effective treatment. Yet, there are often complications, such as rebleeding and intracranial infection, and the optimal timing of intervention is controversial. Besides, this is also a systematic review of the recent advances in epidemiology, pathogenesis, diagnosis, and management of aSAH-associated hydrocephalus.


Aneurysmal subarachnoid hemorrhage; Hydrocephalus; Pathogenesis; Therapeutic development; Management

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Yu-Chang Wang,Xiao-Qiang Wang,Chang-Wu Tan,Chuan-Sen Wang,Zhi Tang,Zhi-Ping Zhang,Jing-Ping Liu,Ge-Lei Xiao. Hydrocephalus after aneurysmal subarachnoid hemorrhage: Epidemiology, Pathogenesis, Diagnosis, and Management. Signa Vitae. 2021. 17(4);4-17.


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