Analysis Of Risk Factors Related To Acute And Chronic Hydrocephalus After Aneurysmal Subarachnoid Hemorrhage

Objective: In order to explore the related risk factors of acute and chronic aneurymatic subarachnoid hemorrhage(a SAH)in western of Guangxi province,this study collected and analyzed clinical data and proposed individualized prevention and treatment programs according to the research results,and took corresponding treatment measures for preventable high risk factors in order to reduce the probability of hydrocephalus.For patients with uncontrollable high risk factors,early critical prevention,early diagnosis and early treatment should be carried out to minimize the harm as far as possible,providing a theoretical basis for the prevention and treatment of hydrocephalus after clinical a SAH.Methods:(1)The case data of a SAH patients with complete data admitted to the Department of Neurosurgery,severe neurosurgery and Neurology in the Affiliated Hospital of Youjiang Medical College for Nationalities from January 2019 to December 2022 were retrospectively analyzed.(2)The patients were divided into acute hydrocephalus group(0-13 d after a SAH),chronic hydrocephalus group(≥14d after a SAH)and non-hydrocephalus group according to the presence of hydrocephalus and the occurrence time of hydrocephalus.Clinical data were collected from each group [including sex,age,hypertension,diabetes,Glasgow(GCS)coma score,modified Fisher scale,Hunt-Hess scale,modified World Federation of Neurosurgical grading system Neurological Societies Scale,m-WFNSS),intraventricular hematoma,aneurysm location,cerebrospinal fluid drainage method and drainage volume,cerebrospinal fluid protein level];(3)Chi-square test and rank-sum test were used to analyze the influencing factors of hydrocephalus.Statistically significant risk factors were selected,and multiple Logistic regression analysis was used to identify independent risk factors.Finally,independent risk factors of acute and chronic hydrocephalus complicated with a SAH were summarized.Results:(1)Gender,age,smoking history and cerebrospinal fluid drainage(P > 0.05)were not statistically significant.There was no significant difference between the four factors in patients with acute hydrocephalus complicated by a SAH and those without hydrocephalus.Eight factors,including hypertension history,GCS score,Hunt-Hess grading,m-WFNSS,modified Fisher grading,aneurysm location,intraventricular hemoperitoneum,and biochemical protein quantitation in cerebrospinal fluid,were statistically significant(P <0.05).It can be considered that there are significant differences between the above 8 factors in patients with acute hydrocephalus after a SAH and those without hydrocephalus.(2)Aneurysm location(P < 0.05),the difference was statistically significant.It can be considered that aneurysm location is an independent risk factor for acute hydrocephalus after a SAH.(3)Age,smoking history,aneurysm location,biochemical protein quantity of cerebrospinal fluid(P >0.05),the difference was not statistically significant.There was no significant difference in the above 4 factors between the group with chronic hydrocephalus complicated with a SAH and the group without hydrocephalus.Among the 8 factors,including gender,history of hypertension,GCS score,Hunt-Hess grading,m-WFNSS,modified Fisher grading,intraventricular hemoperitoneum,and cerebrospinal fluid drainage,P < 0.05 was statistically significant,suggesting that there were significant differences between the above 8 factors complicated with chronic hydrocephalus after a SAH and non-hydrocephalus groups.(4)Previous history of hypertension,modified Fisher grade and cerebrospinal fluid drainage(P <0.05),the difference was statistically significant.It can be considered that history of hypertension,modified Fisher grade and cerebrospinal fluid drainage are independent risk factors for chronic hydrocephalus after a SAH.Conclusions:(1)Hypertension history,GCS score,Hunt-Hess grading,m-WFNSS,modified Fisher grading,aneurysm location,intraventricular hemoperitoneum,biochemical protein quantity in CSF were correlated with acute hydrocephalus after a SAH.Aneurysm location was an independent risk factor for acute hydrocephalus after a SAH.(2)Gender,history of hypertension,GCS score,Hunt-Hess grading,m-WFNSS,modified Fisher grading,intraventricular hematoma,and cerebrospinal fluid drainage were correlated with chronic hydrocephalus after a SAH.History of hypertension,modified Fisher grade,and cerebrospinal fluid drainage were independent risk factors for chronic hydrocephalus after a SAH.