Risk Factors Of Chronic Hydrocephalus After Aneurysmal Subarachnoid Hemorrhage

Objective: Chronic hydrocephalus is a common complication of aneurysmal subarachnoid hemorrhage that seriously affects prognosis.The pathogenesis of chronic hydrocephalus following subarachnoid hemorrhage is still unclear and the relevant risk factors are always under close attention.If potential risk factors leading to chronic hydrocephalus could be recognized at an earlier stage and end up with some correspondent clinical interventions,not only the occurrence of hydrocephalus would be reduced,but also can be used to guide clinical activity and improve prognosis.Methodology: Based on the inclusion and exclusion,203 patients with aneurysmal subarachnoid hemorrhage who have been admitted in the neurosurgical department of Fujian Medical University 2nd Affiliated Hospital from October 2015 to October2019 were enrolled in this study.According to their multiple CT results,these patients were divided into two groups: 30 cases with chronic hydrocephalus and173 without chronic hydrocephalus.By studying literature review,10 possible factors such as gender,age,Hunt-Hess grade before operation,improved Fisher grade before operation,high blood pressure,diabetes,position of the aneurysm,decompressive craniectomy and intracranial infection were chosen to make statistical analysis as well as multi-factor logistic retrospective analysis of factors with statistical significance.On this basis,relevant risk factors of chronic hydrocephalus were found out and further discussed.Result: In this study,there were 203 adult cases of aneurysmal subarachnoid hemorrhage,in which 30(account for 14.78%)are with chronic hydrocephalus and173(account for 85.22%)without chronic hydrocephalus.Single factor analysis showed that Hunt-Hess grade before operation,improved Fisher grades before operation,medical record of high blood pressure,acute hydrocephalus,intracranial infection and decompressive craniectomy were significantly correlated with chronic hydrocephalus(p<0.05),while the age,gender,diabetes,position of aneurysm and treatment(incarceration of aneurysm or interventional embolization)were not significantly correlated with chronic hydrocephalus(P>0.05).Multiple factor analysis indicated that high blood pressure,Hunt-Hess grade before operation and intracranial infection are risk factors of chronic hydrocephalus following the aneurysmal subarachnoid hemorrhage.Conclusion: In summary,chronic hydrocephalus after aneurysmal subarachnoid hemorrhage caused by various factors.The single-factor analytical result indicates that high blood pressure,Hunt-Hess grade before operation,improved Fisher grade before operation,acute hydrocephalus,intracranial infection and decompressive craniectomy are related to chronic hydrocephalus.The multi-factor analytical result indicates that medical record of high blood pressure,Hunt-Hess grade before operation and intracranial infection are independent risk factors of chronic hydrocephalus.Intracranial infection is the most relevant factor of chronic hydrocephalus(P value : 0.000159 and Wald value :14.261).