Clinical analysis of cerebral edema after aneurysm clipping in patients with aneurysmal subarachnoid hemorrhage

Abstract

Background
To explore the clinical analysis of cerebral edema in aneurysmal subarachnoid hemorrhage (aSAH) patients after aneurysm clipping.


Methods
The clinical data of 232 aSAH patients treated with aneurysm clipping in our hospital from May 2016 to May 2022 were retrospectively analyzed. According to whether there was cerebral edema after operation, they were divided into a concurrent group (n = 33) and a non-concurrent group (n = 199). The general data of the two groups were compared, and the risk factors of cerebral edema after aneurysm clipping in aSAH patients were analyzed by univariate and multivariate Logistic regression, and the risk factors were analyzed to predict aSAH jointly.


Results

The complicated group showed higher incidence of hemorrhagic complications and circulatory abnormalities post-localization. In this group, there was a significant increase in patients with Fisher grade III-IV, WFNS grade II, Hunt-Hess grade III-IV, concomitant hypertension, delayed surgery (≥ 12 h), and concomitant hematoma (
P
 < 0.05). It was also confirmed that multiple times of bleeding, posterior circulation aneurysms, Fisher grade Ⅲ-Ⅳ, WFNS grade Ⅱ, Hunt-Hess grade Ⅲ-Ⅳ, hypertension, time from onset to operation ≥ 12 h, and hematoma were all risk factors for cerebral edema after aneurysm clipping in aSAH patients (
P
 < 0.05). Consistency analysis showed that the sensitivity, specificity, accuracy, positive predictive value, negative predictive value and were 0.878, 0.980, 0.970, 0.882 and 0.984 respectively, with a Kappa value of 0.878.



Conclusion
Multiple bleeding times, posterior circulation aneurysm, Fisher grade Ⅲ-Ⅳ, WFNS grade Ⅱ, Hunt-Hess grade Ⅲ-Ⅳ, hypertension, time from onset to operation ≥ 12 h, and hematoma are all risk factors for brain edema after aneurysm clipping in aSAH patients.