gms | German Medical Science

60th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Benelux countries and Bulgaria

German Society of Neurosurgery (DGNC)

24 - 27 May 2009, Münster

A new categorizing system for obstructive hydrocephalus in intraventricular haemorrhage

Meeting Abstract

  • M. Stein - Neurochirurgische Klinik, Universitätsklinikum Gießen und Marburg GmbH, Standort Gießen
  • M. Luecke - Klinik für Neurochirurgie, Asklepios Klinik Altona, Hamburg
  • M. Oertel - Neurochirurgische Klinik, Universitätsklinikum Gießen und Marburg GmbH, Standort Gießen
  • M. Preuss - Neurochirurgische Klinik, Universitätsklinikum Gießen und Marburg GmbH, Standort Gießen
  • U. Nestler - Neurochirurgische Klinik, Universitätsklinikum Gießen und Marburg GmbH, Standort Gießen
  • D.-K. Boeker - Neurochirurgische Klinik, Universitätsklinikum Gießen und Marburg GmbH, Standort Gießen
  • A. Joedicke - Klinik für Neurochirurgie, Vivantes Klinikum Neukölln, Berlin

Deutsche Gesellschaft für Neurochirurgie. 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien. Münster, 24.-27.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. DocMO.03-06

DOI: 10.3205/09dgnc015, URN: urn:nbn:de:0183-09dgnc0153

Published: May 20, 2009

© 2009 Stein et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

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Objective: Acute hydrocephalus is a life-threatening complication of intraventricular haemorrhage (IVH). Obstructive hydrocephalus is a dynamic process, and not every hydrocephalus is life-threatening. The definition of acute hydrocephalus was not standardized in the literature. To date, no categorizing system exists in the literature that quantifies obstructive hydrocephalus.

Methods: CT scans from 155 patients who suffered from secondary IVH were reviewed by two independent investigators. A new system was developed to grade hydrocephalus on the basis of visual criteria into absent, beginning, moderate and severe. The new system was compared to the hydrocephalus score of Diringer (0–24) and to Evans’ index. In order to evaluate the interrater reliability of the hydrocephalus grading system, 20 CT scans were scored by five independent clinicians, and the intraclass correlation coefficient was calculated.

Results: Beginning, moderate, and severe hydrocephalus occurred in 19%, 52%, and 21% of the patients, respectively. Hydrocephalus was absent in 8%. Intraclass correlation coefficient for interrater hydrocephalus scoring was 0.84. Mean Evans’ index was 0.31 (SD: ±0.05). According to the method of Diringer, hydrocephalus was present in 99% of the patients in the cohort. Median hydrocephalus score was 10 (range 4 to 21). There was a moderately strong, positive correlation between the results of the 4-point categorizing system and the Diringer score (τ=0.81, p=<0.001).

Conclusions: The newly developed categorizing system for obstructive hydrocephalus is a simple grading scale and a useful tool in clinical studies and in clinical standard protocols.