{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T10:33:47Z","timestamp":1782556427695,"version":"3.54.5"},"reference-count":24,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2015,12]]},"abstract":"\nOBJECT<\/jats:title>\nThe present study aimed to investigate aneurysm locations and treatments for ruptured cerebral aneurysms associated with secondary normal-pressure hydrocephalus (sNPH) after subarachnoid hemorrhage (SAH) by using comprehensive data from the Japanese Stroke DataBank.<\/jats:p><\/jats:sec>\n\nMETHODS<\/jats:title>\nAmong 101,165 patients with acute stroke registered between 2000 and 2013, 4693 patients (1482 men, 3211 women) were registered as having had an SAH caused by a ruptured saccular aneurysm. Of them, 1448 patients (438 men and 1010 women; mean age 61.9 \u00b1 13.4 years) who were confirmed to have or not have coexisting acute hydrocephalus and sNPH were included for statistical analyses. Locations of the ruptured aneurysms were subcategorized into 1 of the following 4 groups: middle cerebral artery (MCA; n = 354), anterior communicating artery and anterior cerebral artery (ACA; n = 496), internal carotid artery (ICA; n = 402), and posterior circulation (n = 130). Locations of 66 of the ruptured aneurysms were unknown\/unrecorded. Treatments included craniotomy and clipping alone in 1073 patients, endovascular coil embolization alone in 285 patients, and a combination of coiling and clipping in 17 patients. The age-adjusted and multivariate odds ratios from logistic regression analyses were calculated after stratification using the Fisher CT scale to investigate the effects of the hematoma volume of SAH.<\/jats:p><\/jats:sec>\n\nRESULTS<\/jats:title>\nAcute hydrocephalus was confirmed in 593 patients, and 521 patients developed sNPH. Patients with a ruptured ACA aneurysm had twice the risk for sNPH over those with a ruptured MCA aneurysm. Those with an ACA aneurysm with Fisher Grade 3 SAH had a 9-fold-higher risk for sNPH than those with an MCA aneurysm with Fisher Grade 1 or 2 SAH. Patients with a ruptured posterior circulation aneurysm did not have any significant risk for sNPH. Clipping of the ruptured aneurysm resulted in twice the risk for sNPH over coil embolization alone.<\/jats:p><\/jats:sec>\n\nCONCLUSIONS<\/jats:title>\nPatients with low-grade SAH caused by a ruptured MCA aneurysm had a low risk for the development of sNPH. In contrast, patients with high-grade SAH caused by a ruptured ACA aneurysm had a higher risk for sNPH. Endovascular coiling might confer a lower risk of developing sNPH than microsurgical clipping.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2015.1.jns142761","type":"journal-article","created":{"date-parts":[[2015,7,31]],"date-time":"2015-07-31T13:59:54Z","timestamp":1438351194000},"page":"1555-1561","source":"Crossref","is-referenced-by-count":45,"title":["Aneurysm location and clipping versus coiling for development of secondary normal-pressure hydrocephalus after aneurysmal subarachnoid hemorrhage: Japanese Stroke DataBank"],"prefix":"10.3171","volume":"123","author":[{"given":"Shigeki","family":"Yamada","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Stroke Center and Normal Pressure Hydrocephalus Center, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masatsune","family":"Ishikawa","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Stroke Center and Normal Pressure Hydrocephalus Center, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuo","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Stroke Center and Normal Pressure Hydrocephalus Center, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tadashi","family":"Ino","sequence":"additional","affiliation":[{"name":"Department of Neurology, Rakuwakai Otowa Hospital;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toru","family":"Kimura","sequence":"additional","affiliation":[{"name":"Department of Neurology, Rakuwakai Misasagi Hospital, Kyoto; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shotai","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Shimane University, Shimane, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"_","family":"_","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns142761","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"44","DOI":"10.3171\/2008.5.17560","article-title":"Prediction of ventriculoperitoneal shunt dependency in patients with aneurysmal subarachnoid hemorrhage","volume":"110","author":"Chan","year":"2009"},{"key":"b2-jns142761","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"1711","DOI":"10.1161\/STR.0b013e3182587839","article-title":"Guidelines for the management of aneurysmal subarachnoid hemorrhage: a guideline for healthcare professionals from the American Heart Association\/American Stroke Association","volume":"43","author":"Connolly","year":"2012"},{"key":"b3-jns142761","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"924","DOI":"10.1227\/01.neu.0000303188.72425.24","article-title":"Risk of shunt-dependent hydrocephalus after occlusion of ruptured intracranial aneurysms by surgical clipping or endovascular coiling: a single-institution series and metaanalysis","volume":"61","author":"de Oliveira","year":"2007"},{"key":"b4-jns142761","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"402","DOI":"10.3171\/jns.2004.101.3.0402","article-title":"Shunt-dependent hydrocephalus after rupture of intracranial aneurysms: a prospective study of the influence of treatment modality","volume":"101","author":"Dehdashti","year":"2004"},{"key":"b5-jns142761","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"763","DOI":"10.1227\/01.NEU.0000053222.74852.2D","article-title":"Factors related to hydrocephalus after aneurysmal subarachnoid hemorrhage","volume":"52","author":"Dorai","year":"2003"},{"key":"b6-jns142761","series-title":"Arch Neurol","doi-asserted-by":"publisher","first-page":"744","DOI":"10.1001\/archneur.1989.00520430038014","article-title":"Factors associated with hydrocephalus after subarachnoid hemorrhage. 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