シロスタゾール投与によるくも膜下出血後水頭症の発生抑制の可能性

抄録

The development of shunt-dependent hydrocephalus is a well-known complication of aneurysmal subarachnoid hemorrhage (SAH). Cilostazol is known to prevent the development of symptomatic vasospasm after aneurysmal SAH. We retrospectively analyzed 153 patients with SAH admitted to our hospital between January 2008 and December 2014 to determine whether cilostazol inhibits development of hydrocephalus. Patients with SAH of unknown origin, traumatic SAH, and mycotic aneurysm were excluded, and 98 patients were studied. Of these, 64 received cilostazol and 34 did not. Clinical factors including cerebrospinal fluid diversion were examined in each group. The cilostazol group was associated with lower incidence of shunt-dependent hydrocephalus after aneurysmal SAH (cilostazol (-), 11 of 34 patients [32%]; cilostazol (+), 9 of 64 patients [14%]; p=0.039). The findings suggested that cilostazol may suppress the development of post-SAH shunt-dependent hydrocephalus, although further studies are needed to elucidate the precise role of cilostazol in the development of hydrocephalus.