Shikher Shrestha
National Institute of Neurological and Allied Sciences, Nepal
Title: P-SSIH- Predictors of shunt dependency in spontaneous hypertensive intracerebral haemorrhage
Biography
Biography: Shikher Shrestha
Abstract
Predictors of Shunt dependency in Spontaneous Hypertensive Intracerebral Haemorrhage (P-SSIH): Spontaneous Intracerebral hemorrhage (SICH) has a significant toll on morbidity and mortality with estimated annual affection of >1 million people worldwide. The most common risk factor being uncontrolled hypertension. The incidence is even higher in Asian population, partly due to limited care for hypertension and non-compliance. Frequently, SICH is complicated by acute hydrocephalus, necessitating emergency CSF diversion with a subset of patients, ultimately requiring long-term permanent Shunt diversion. The factors predicting need for ventricular shunt placement in SICH patient population is unclear. We try to analyse various factors that might have significant contributory effect for the need for long-term shunt placement in SICH patients.We performed a retrospective analysis of 48 patients out of 125 patients with hypertensive intracerebral hemorrhage intervened surgically at National Institute of Neurological and Allied Sciences, Bansbari, Nepal between 2015 to 2017. A multiple logistic regression model was developed to identify independent predictors of shunt-dependency after SICH. We included various clinical, radiological and interventional variables. Infratentorial Location of SICH, volume, initial hydrocephalus, intraventricular extension of bleed, third ventricular ballooning, need for craniotomy and initial EVD placement has a significant association for predicting long term shunt dependency; though does not show significant increase in risk.