Treatment of subdural effusion with hydrocephalus after ruptured intracranial aneurysm clipping.

OBJECTIVE: This study was conducted to determine whether a ventriculoperitoneal shunt alone was effective in treating subdural effusion with hydrocephalus.
METHODS: Using only a ventriculoperitoneal shunt, we successfully treated eight patients who had subdural effusion with hydrocephalus after ruptured intracranial aneurysmal clipping, despite ventricular deformity and midline shift.
RESULTS: For all of the patients, both the subdural effusion and ventriculomegaly subsided and clinical symptoms lessened after surgery.
CONCLUSION: Ventriculoperitoneal shunting alone is an effective and satisfactory procedure; no subdural peritoneal shunt is needed for patients with subdural effusion accompanied by hydrocephalus. To-and-fro communication between the subdural effusion and ventricles is considered to be present in these patients. When selecting the treatment for subdural effusion, it is important to consider whether hydrocephalus (disturbance of cerebrospinal fluid circulation) is present.