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Chronic hydrocephalus after subarachnoid hemorrhage may become inevitable, necessitating a permanent cerebrospinal fluid shunt. We report a 40-year-old woman with SAH and a CHESS score of 6. We implemented the IRRAflow active irrigation and drainage system which expedited hemorrhage clearance in 4 days compared to one or two weeks longer with standard external ventricular drains. This system reduced the inflammatory load and preserved the arachnoid granulations, which are responsible for CSF resorption. Further, expedited recanalization of the fourth ventricle prevented an exponential increase in intracranial pressure. Collectively, these factors prevented CSF shunt dependency.
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Salman et al. (2025) studied this question.
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