Hydrocephalus occurs frequently after stroke and has been reported to affect the functional outcome. We investigated 77 stroke patients retrospectively to evaluate whether or not hydrocephalus affects the functional outcome. The patients were divided into three groups: Group 1, 20 patients without hydrocephalus; Group 2, 28 patients with early onset hydrocephalus; Group 3, 29 patients with delayed onset hydrocephalus. Functional status was evaluated by 3 functional indices, Mini-Mental Status Examination(MMSE), Barthel index, and PULSES profile. These 3 functional indices were compared between pre- and post-rehabilitation stages in Groups 1 and 2, and compared among pre-rehabilitation, post-hydrocephalus, and post-rehabilitation stages in Group 3.

Significant functional improvements were shown in the post-rehabilitation stage in Groups 1 and 2 (P<0.05). In Group 3, the functional improvements were shown in the post-rehabilitation stage when compared to the pre-rehabilitation stage, but without statistical significance. However, significant functional improvements were demonstrated in the post-rehabilitation stage compared to the post-hydrocephalus stage in Group 3 (P<0.05). In comparing the three groups, the final functional outcome was found to be best in Group 1 and worst in Group 3.

We suggest that the time from the onset of hydrocephalus to diagnosis and management is more important than the presence of hydrocephalus itself in the stroke patient in respect to functional outcome.