Complications
Chronic hydrocephalus is a well-known complication after aneurysmal SAH, occurring in >20% of patients.[208] For people with persistent or progressive symptoms and a clinical diagnosis of chronic hydrocephalus, drainage or permanent diversion of cerebrospinal fluid should be considered. If there is uncertainty about the likely benefit of permanent diversion, a trial of temporary drainage to assess the need for permanent diversion should be considered.[38] Lamina terminalis fenestration plays a crucial role in chronic hydrocephalus prevention. The technique can be accomplished when a craniotomy is performed for aneurysm clipping. Although the overall literature supports this technique, a well-designed, multi-centre, randomised controlled trial is needed to strongly demonstrate its effectiveness.[209]
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