Acute hydrocephalus and delayed cerebral infarction after aneurysmal subarachnoid hemorrhage

医学 脑积水 蛛网膜下腔出血 血管痉挛 脑血管痉挛 脑梗塞 梗塞 神经组阅片室 心脏病学 神经外科 神经学 麻醉 内科学 外科 缺血 心肌梗塞 精神科
作者
Axel Masson,Grégoire Boulouis,Kévin Janot,Denis Herbreteau,Jean-Phlippe Cottier,Richard Bibi,Clara Cohen,Sandra Obry,Stéphane Velut,Aymeric Amelot,Héloïse Ifergan
出处
期刊:Acta neurochirurgica [Springer Science+Business Media]
卷期号:164 (9): 2401-2408 被引量:6
标识
DOI:10.1007/s00701-022-05321-8
摘要

BackgroundDelayed cerebral infarction (DCIn) following aneurysmal subarachnoid hemorrhage (aSAH) is a major cause of morbi-mortality; yet, the causes for DCIn remain incompletely understood.ObjectiveWe tested the hypothesis that acute hydrocephalus could be related to the occurrence of DCIn, independently of the occurrence and severity of vasospasm.MethodsRadiological and clinical data of patients treated at a single large volume academic center for aSAH between 2017 and 2019 were retrospectively analyzed. DCIn was defined as imaging stigma of cerebral infarction visible on 6-week imaging follow-up after aSAH. Hydrocephalus was defined on baseline imaging as a relative bicaudate index above 1. Cerebral vasospasm was defined by reduction of artery diameter in comparison with initial diameter. We used uni- and multivariable models to test the associations between these variables, hydrocephalus and DCIn.ResultsOf 164 included patients, vasospasm occurred in 58 patients (35.4%), and DCIn in 47 (28.7%). Acute hydrocephalus was present in 85 patients (51.8%) on baseline CT. No relation was found between acute hydrocephalus and delayed cerebral infarction in our multivariate analysis (adjusted OR: 1.20 95% CI [0.43–3.37]; p = 0.732). Only vasospasm occurrence was independently associated with DCIn (adjusted OR: 10.97 95% CI [4.60–26.01]).ConclusionOur study did not show an association between acute hydrocephalus and DCIn after aSAH, after adjustment for the presence and severity of cerebral vasospasm.
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