Intraventricular blood and ventricular dilatation on the CT within 24 hours after a subarachnoid hemorrhage due to a ruptured intracranial aneurysm

CT of 57 patients with ruptured intracranial aneurysms, who were examined within 24 hours after their first onset, are evaluated. The correlation between the intraventricular blood, the ventricular dilatation, and the degree and extension of subarachnoid hemorrhage is investigated in order to determine how necessary a shunt operation seems. The results may be summarized as follows: 1. Intraventricular blood was classified in 3 types - 21 cases of the niveau type, 10 cases of the reflux-clot type, and 14 cases of the ruptured type. All cases of the reflux-clot type were found only within 6 hours after a subarachnoid hemorrhage. The blood clot seemed to be caught on the choroid plexus near Monro's foramen. 2. The ventricular dilatation depended mainly on the volume of the intraventricular blood. There was not a close relation to the degree and extension of the subarachnoid hemorrhage. Age may be related to the cause of intraventricular blood, and the ventricular dilatation which was detected on the CT within 24 hours after a subarachnoid hemorrhage may be minimal, if most cases of the ruptured type are excluded. 3. 15 cases of the 33 cases which were not moribund or which had no complications had shunt operations within between 2 weeks and one year after a subarachnoid hemorrhage. Those 15 cases included all 3 cases of the ruptured type and all 6 cases of the reflux-clot type, but only 3 of the 13 cases of the niveau type. The shunt operation had nothing to do with the degree and extension of the subarachnoid hemorrhage or with the ventricular dilatation on the CT within 24 hours after the first onset. (author)