{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T11:32:54Z","timestamp":1790940774894,"version":"4.1.0"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,12,7]],"date-time":"2023-12-07T00:00:00Z","timestamp":1701907200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>The development of persistent hydrocephalus in patients after spontaneous intracerebral hemorrhage (ICH) is still poorly understood, and many variables predicting the need for a cerebrospinal fluid (CSF)-shunt have been described in the literature with varying results. The aim of this study is to find predictive factors for shunt dependency.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a retrospective, single-center study of 99 neurosurgically treated patients with spontaneous ICH. Variables, including age, Glasgow Coma Scale (GCS), intraventricular hemorrhage (IVH), location of hemorrhage, acute hydrocephalus, and volumetric analysis of IVH, ICH, and intraventricular CSF were compared between patients with and without CSF-shunt implantation. Furthermore, receiver operating characteristics (ROC) for ICH, IVH, and intraventricular CSF volume parameters were calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>CSF-shunt implantation was performed significantly more often in patients after thalamic (<jats:italic>p<\/jats:italic>\u2009=\u20090.03) and cerebellar ICH (<jats:italic>p<\/jats:italic>\u2009=\u20090.04). Moreover, a lower ratio between the total hemorrhage volume and intraventricular CSF volume (<jats:italic>p<\/jats:italic>\u2009=\u20090.007), a higher IVH distribution in the third ventricle, and an acute hydrocephalus (<jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001) with an increased intraventricular CSF volume (<jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001) were associated with shunt dependency. Our ROC model demonstrated a sensitivity of 82% and a specificity of 65% to predict the necessity for a shunt at a cutoff value of 1.9 with an AUC of 0.835.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Volumetric analysis of ICH, IVH, and intraventricular CSF may improve the prediction of CSF shunt implantation in patients with spontaneous ICH.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2023.1255477","type":"journal-article","created":{"date-parts":[[2023,12,21]],"date-time":"2023-12-21T15:00:14Z","timestamp":1703170814000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Predicting the need for cerebrospinal fluid shunt implantation after spontaneous intracerebral hemorrhage: a challenging task"],"prefix":"10.3389","volume":"14","author":[{"given":"Farjad","family":"Khalaveh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vitalij","family":"Zeiser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Cho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Schmelzer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Reinprecht","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Herta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl","family":"Roessler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Dorfer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,12,7]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1016\/S1474-4422(09)70340-0","article-title":"Incidence, case fatality, and functional outcome of intracerebral haemorrhage over time, according to age, sex, and ethnic origin: a systematic review and meta-analysis","volume":"9","author":"van Asch","year":"2010","journal-title":"Lancet Neurol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1016\/S1474-4422(09)70025-0","article-title":"Worldwide stroke incidence and early case fatality reported in 56 population-based studies: a systematic review","volume":"8","author":"Feigin","year":"2009","journal-title":"Lancet Neurol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"891","DOI":"10.1161\/01.STR.32.4.891","article-title":"The ICH score: a simple, reliable grading scale for intracerebral hemorrhage","volume":"32","author":"Hemphill","year":"2001","journal-title":"Stroke"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"848","DOI":"10.1212\/01.wnl.0000304930.47751.75","article-title":"Intraventricular hemorrhage: anatomic relationships and clinical implications","volume":"70","author":"Hallevi","year":"2008","journal-title":"Neurology"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1007\/3-211-30714-1_16","article-title":"Intraventricular hemorrhage and hydrocephalus after spontaneous intracerebral hemorrhage: results from the STICH trial","volume":"96","author":"Bhattathiri","year":"2006","journal-title":"Acta Neurochir Suppl"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1007\/s12028-007-9018-y","article-title":"Predictors of ventriculoperitoneal shunting after spontaneous intraparenchymal hemorrhage","volume":"8","author":"Miller","year":"2008","journal-title":"Neurocrit Care"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"E5","DOI":"10.3171\/2012.2.FOCUS11372","article-title":"Predictors of long-term shunt-dependent hydrocephalus in patients with intracerebral hemorrhage requiring emergency cerebrospinal fluid diversion","volume":"32","author":"Zacharia","year":"2012","journal-title":"Neurosurg Focus"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1007\/3-211-30714-1_45","article-title":"Hydrocephalus in a rat model of intraventricular hemorrhage","volume":"96","author":"Lodhia","year":"2006","journal-title":"Acta Neurochir Suppl"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1007\/s12028-018-0532-x","article-title":"Prediction of shunt dependency after intracerebral hemorrhage and intraventricular hemorrhage","volume":"29","author":"Kuo","year":"2018","journal-title":"Neurocrit Care"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1007\/s12975-020-00823-y","article-title":"Long-term outcomes and risk factors related to hydrocephalus after intracerebral hemorrhage","volume":"12","author":"Hu","year":"2021","journal-title":"Transl Stroke Res"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"725","DOI":"10.3389\/fneur.2018.00725","article-title":"Influence of admission blood glucose in predicting outcome in patients with spontaneous intracerebral hematoma","volume":"9","author":"Kongwad","year":"2018","journal-title":"Front Neurol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"181","DOI":"10.23736\/S0390-5616.19.04641-1","article-title":"Shunt-dependent hydrocephalus after aneurysmal subarachnoid hemorrhage","volume":"64","author":"Di Russo","year":"2020","journal-title":"J Neurosurg Sci"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1016\/j.wneu.2022.08.089","article-title":"Review of the prevention and treatment of hydrocephalus after aneurysmal subarachnoid hemorrhage","volume":"168","author":"Yang","year":"2022","journal-title":"World Neurosurg"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"969","DOI":"10.1097\/CCM.0b013e318198683a","article-title":"The IVH score: a novel tool for estimating intraventricular hemorrhage volume: clinical and research implications","volume":"37","author":"Hallevi","year":"2009","journal-title":"Crit Care Med"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1108","DOI":"10.1161\/STROKEAHA.118.022694","article-title":"Surgical decision making in brain hemorrhage","volume":"50","author":"Gregson","year":"2019","journal-title":"Stroke"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1016\/S0140-6736(13)60986-1","article-title":"Early surgery versus initial conservative treatment in patients with spontaneous supratentorial lobar intracerebral haematomas (STICH II): a randomised trial","volume":"382","author":"Mendelow","year":"2013","journal-title":"Lancet"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1016\/S0140-6736(05)70233-6","article-title":"Early surgery versus initial conservative treatment in patients with spontaneous supratentorial intracerebral haematomas in the international surgical trial in intracerebral Haemorrhage (STICH): a randomised trial","volume":"365","author":"Mendelow","year":"2005","journal-title":"Lancet"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1007\/s100720200020","article-title":"External ventricular drainage for acute obstructive hydrocephalus developing following spontaneous intracerebral haemorrhages","volume":"23","author":"Sumer","year":"2002","journal-title":"Neurol Sci"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1196","DOI":"10.1212\/WNL.28.11.1196","article-title":"Bicaudate index in computerized tomography of Huntington disease and cerebral atrophy","volume":"28","author":"Barr","year":"1978","journal-title":"Neurology"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"355","DOI":"10.3171\/jns.1985.63.3.0355","article-title":"Acute hydrocephalus after aneurysmal subarachnoid hemorrhage","volume":"63","author":"van Gijn","year":"1985","journal-title":"J Neurosurg"},{"key":"ref21","first-page":"1454","article-title":"Temporal horn index and volume of medial temporal lobe atrophy using a new semiautomated method for rapid and precise assessment","volume":"27","author":"Giesel","year":"2006","journal-title":"AJNR Am J Neuroradiol"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1179\/1743132812Y.0000000121","article-title":"CT evaluation of lateral ventricular dilatation after subarachnoid hemorrhage: baseline bicaudate index values [correction of balues]","volume":"35","author":"Dupont","year":"2013","journal-title":"Neurol Res"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"586","DOI":"10.3171\/2015.11.JNS152094","article-title":"Meta-analysis and systematic review of risk factors for shunt dependency after aneurysmal subarachnoid hemorrhage","volume":"126","author":"Wilson","year":"2017","journal-title":"J Neurosurg"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"2401","DOI":"10.1007\/s00701-022-05321-8","article-title":"Acute hydrocephalus and delayed cerebral infarction after aneurysmal subarachnoid hemorrhage","volume":"164","author":"Masson","year":"2022","journal-title":"Acta Neurochir"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1007\/s12028-015-0152-7","article-title":"Factors associated with acute and chronic hydrocephalus in nonaneurysmal subarachnoid hemorrhage","volume":"24","author":"Kang","year":"2016","journal-title":"Neurocrit Care"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1148\/radiol.2017161216","article-title":"Diagnosis of Normal-pressure hydrocephalus: use of traditional measures in the era of volumetric MR imaging","volume":"285","author":"Miskin","year":"2017","journal-title":"Radiology"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1187","DOI":"10.3174\/ajnr.A6620","article-title":"Ventricular volume is more strongly associated with clinical improvement than the evans index after shunting in idiopathic normal pressure hydrocephalus","volume":"41","author":"Neikter","year":"2020","journal-title":"AJNR Am J Neuroradiol"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"931","DOI":"10.1001\/archneurpsyc.1942.02290060069004","article-title":"An encephalographic ratio for estimating ventricular enlargement and cerebral atrophy","volume":"47","author":"Evans","year":"1942","journal-title":"Arch Neurol Psychiatr"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"S4","DOI":"10.1227\/01.NEU.0000168185.29659.C5","article-title":"Diagnosing idiopathic normal-pressure hydrocephalus","volume":"57","author":"Relkin","year":"2005","journal-title":"Neurosurgery"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"661","DOI":"10.1007\/s00234-020-02361-8","article-title":"A new index for assessing cerebral ventricular volume in idiopathic normal-pressure hydrocephalus: a comparison with Evans\u2019 index","volume":"62","author":"He","year":"2020","journal-title":"Neuroradiology"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"939","DOI":"10.1227\/NEU.0b013e318208f5e0","article-title":"Evans' index revisited: the need for an alternative in normal pressure hydrocephalus","volume":"68","author":"Toma","year":"2011","journal-title":"Neurosurgery"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"1021","DOI":"10.1016\/S0140-6736(19)30195-3","article-title":"Efficacy and safety of minimally invasive surgery with thrombolysis in intracerebral haemorrhage evacuation (MISTIE III): a randomised, controlled, open-label, blinded endpoint phase 3 trial","volume":"393","author":"Hanley","year":"2019","journal-title":"Lancet"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"1304","DOI":"10.1161\/01.STR.27.8.1304","article-title":"The ABCs of measuring intracerebral hemorrhage volumes","volume":"27","author":"Kothari","year":"1996","journal-title":"Stroke"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"582","DOI":"10.3340\/jkns.2021.0142","article-title":"Prediction of shunt-dependent hydrocephalus after primary supratentorial intracerebral hemorrhage with a focus on the influence of craniectomies","volume":"65","author":"Park","year":"2022","journal-title":"J Korean Neurosurg Soc"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1212\/WNL.0000000000004155","article-title":"Permanent CSF shunting after intraventricular hemorrhage in the CLEAR III trial","volume":"89","author":"Murthy","year":"2017","journal-title":"Neurology"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2023.1255477\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,21]],"date-time":"2023-12-21T15:00:17Z","timestamp":1703170817000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2023.1255477\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,7]]},"references-count":35,"alternative-id":["10.3389\/fneur.2023.1255477"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2023.1255477","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,7]]},"article-number":"1255477"}}