The Effect of Lamina Terminalis Fenestration during Aneurysmal Clipping on the Incidence of Post Aneurysmal Subarachnoid Hemorrhage Hydrocephalus: A Retrospective Study | ||
| The Medical Journal of Cairo University | ||
| Volume 93, Issue 09, September 2025, Pages 1055-1058 PDF (25.87 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/mjcu.2025.464220 | ||
| Author | ||
| WALID E. ELHALABY, M.D.*; AHMED KOHEIL, M.D.** OMAR ABDELALEEM RAGAB, M.D.** | ||
| The Department of Neurosurgery, Faculty of Medicine, Cairo University* and Department of Neurosurgery, Faculty of Medicine, Beni Suef University** | ||
| Abstract | ||
| Background: Hydrocephalus is a common and devastating complication following subarachnoid hemorrhage from a rup-tured cerebral aneurysm whether acute or chronic hydroceph-alus which may cause neurological deficits and shunt depend-ency. The lamina terminalis is a sheet of grey matter and pia which when fenestrated acts as a ventriculostomy functioning as form of CSF diversion. Aim of Study: The aim of the study is to establish the value of Lamina terminalis fenestration during surgical clipping of a ruptured aneurysm on post subarachnoid hemorrhage caused hydrocephalus. Patients and Methods: This is a retrospective study done on 60 cases presented to the Neurosurgery Department of Kasr Al-Ainy Hospital from Nov. 2012 to May 2022 with spontane-ous subarachnoid hemorrhage from an anterior circulation an-eurysm that were operated upon through a pterional approach with fenestration of lamina terminalis done to all the patients even if there was no signs of Hydrocephalus, Evaluation of the cases was clinical using Hunt and Hess classification subarach-noid hemorrhage was evaluated by a CT scan of the brain using fisher grading and the aneurysm was diagnosed and located using a CT angiography, digital subtraction or both. Hunt and Hess grade 5 and post circulation aneurysms were excluded from our study. Results: Study was done on 60 patients with the age range from 30 to 70 years, 38 of our patients were male 22 were female (F/M 1:1.7), with 36 known diabetic patients 40 hy-pertensive patients and 45 known smokers. Using the clinical Hunt and Hess grading 30 patients were grade 1 (50%), 14 were grade 2 (23%), 10 were grade 3 (16.6%), grade 4 were 6 patients (10%). From our 60 patients 20 developed ventricu-lomegaly; only 6 patients needed CSF diversion, 4 were imme-diately postoperative, 2 was 3 weeks after surgery. Conclusion: So in regards to our study lamina terminalis fenestration decreased the incidence of post-operative hydro-cephalus. | ||
| Keywords | ||
| Aneurysm; Hydrocephalus; Lamina Terminalis | ||
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