| BACKGROUND & AIM: Subarachnoid hemorrhage caused by ruptured intracranial aneurysm,its acute and serious,while cerebral infarction,as the most common complication of aSAH,has high disability rate and mortality rate,which is the main risk factor for poor prognosis.Previous studies have shown that cerebral infarction after aSAH is the result of multiple factors.this study will be based on CTA,by measuring and analyzing the morphological parameters of the aneurysm,peripheral vascular variation and other imaging-related parameters to explore the risk factors and possible mechanisms of cerebral infarction in aSAH,and to provide a theoretical basis for clinical work and some prospective studies in the future.Methods: From July 2018 to June 2020,patients with aneurysmal subarachnoid hemorrhage were diagnosed by cranial CTA examination at the imaging center of the first affiliated Hospital of Xinjiang Medical University,Total951 cases,After strict inclusion of exclusion criteria,A total of 80 patients with new cerebral infarction after admission,This is the case group;SPSS26.0 software was used to conduct a 1:1 case-control match for the remaining 871 patients with subarachnoid hemorrhage during the same period,the control-factors is gender,age,and ethnicity.In other words,There are 80 patients with aneurysmal subarachnoid hemorrhage without cerebral infarction during the study,This is the control group;There are a total of 160 patients.Collect all thes patient’s blood pressure at the time of aSAH,at the same time,get the modified Fisher grade of aSAH patiends based on the plain scan,And through CTA image reconstruction,To measure the morphological parameters of aneurysms such as the maximum diameter,width,vertical height,neck width,and diameter of the artery,CTA parameters such as the degree of arterial vasospasm.Results: By univariate analysis,there were 62(77.5%)patients with hypertension in the infarction group,18(22.5%)non-hypertensive patients,25(31.3%)non-infarcted hypertensive patients,55(68.8)non-hypertensive patients.The average length of aneurysms in infarct and non-infarct groups was 4.028 mm±1.565 mm and 5.896 mm±3.43 mm,Tumor width 2.901mm±1.319 mm and 3.986 mm±2.18 mm,Vertical height 3.839 mm±1.534 mm and 5.610mm±3.182 mm,Tumor neck width 2.123 mm±0.987 mm and 2.811 mm±1.18 mm,dimension ratio 1.953 mm±0.725 mm and 2.726 mm±1.471 mm;In the infarction group,there were 13(16.3)modified Fisher class Ⅰ patients,31(38.8%)Class Ⅱ patients,23(28.8%)Class Ⅲ patients,13(16.3)Class Ⅳ patients.In the non-infarction group,there were26(32.5%)modified Fisher class Ⅰ patients,35(43.8%)Class Ⅱ patients,13(16.3%)Class Ⅲ patients,6(7.5%)Class Ⅳ patients.In the infarction group,There were 21(26.3%)Patients without intervention,49(61.3%)patients Who were treated by craniotomy,10(12.5%)patients treated by Embolists;In the non-infarction group,There were 45(56.3%)Patients without intervention,28(35.0%)patients Who were treated by craniotomy,7(8.8%)patients treated by Embolists.All the above parameters were statistically significant(P<0.05);Among the factors of mean diameter,incident angle,aspect ratio,,vasospasm degree and Willis ring variation,There was no significant difference between the two groups.For multi-logical regression analysis,blood pressure and craniotomy were significant factors affecting cerebral infarction in aSAH,in which the incidence of infarction in hypertensive patients was 10.677 times that in non-hypertensive patients,and the incidence of infarction after craniotomy was 4.214 times that of non-intervention.Conclusions: Blood pressure,aneurysm size,modified Fisher grading,and craniotomy are risk factors for aSAH cerebral infarction,while blood pressure and intervention are significant influencing factors for aSAH cerebral infarction and can positively predict the occurrence of cerebral infarction. |
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