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Diagnosis of hydrocephalus after aneurysmal subarachnoid hemorrhage has been facilitated by CT, but the true incidence and pathogenesis of the condition remain to be clarified. Extent of ventricular dilatation does not necessarily correlate with clinical symptoms and the indication of shunting operation is by no means definite. Consecutive 117 patients with ruptured aneurysm were retrospectively studied for possible factor(s) for development of hydrocephalus in the chronic stage. The incidence of chronic hydrocephalus was found to be high in those patients with aneurysm of the anterior communicating artery, those harboring acute hydrocephalus, those admitted with higher clinical grades, those showing thick clots and gyral enhancement on initial CT, and those who received tranexamic acid in excess of 30 g.
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