Analysis On The Predictors Of Delayed Ischemic Neurological Deficits After Aneurysmal Subarachnoid Hemorrhage

Background and Purpose : Aneurysmal subarachnoid hemorrhage is associated with a mortality rate of 32%-67% annually. Although early surgical or endovascular protection of ruptured aneurysms has allowed aggressive post-operation management in this patient population, parts of patients with devastating complications died or survived with severe disability. Delayed ischemic deficits(DIDs) is one of the most severe complications afflicted 32.4%-42% patients and caused mobility and mentality rate of 15%-20%.DIDs has became the most important reason of mobility and mentality after aSAH. This article will analysis the predicator of DIDs .Method: We retrospected 344 patients who suffered aneurysmal subarachnoid hemorrhage, and all the aneurysms were clipped by the same skilled neurosurgery doctor. The predictors of DIDs included cerebral vasospasm,the location of aneurysm,hypertension,high level of serum glucose,temporary arterial occlusion( TOA) and the scale when admitted. We analysis the predictors in statistics using Pearson's Chi-square test.Result: 1. Cerebral vasospasm is a very importantpredictor of DIDs .DIDs is related to the severity of vasospasm. 2. The clinical grade of SAH and the HHS have weak correlation to the development of DIDs. 3. There is no evidence of a correlation between DIDs and the location of aneurysm. 4. The patients with previous history of hypertension can also get a good prognosis. The incidence of DIDs is not age-related.5. The high level of serum glucose is the predictor of DIDs. The level of serum affected the prognosis seriously. 6. Under the use of brain-protection technique, TAO lasting less than 20 minutes is much safe.Conclusion: Among the predictors of the development of DIDs, the severe vasospasm and the high level of serum glucose is related to the DIDs.We didn't find evidence of DIDs related to the other factors.