Bang Ji Hoon, Na Min Kyun, Kim Choong Hyun, Kim Jae Min, Cheong Jin Hwan, Ryu Je Il, Han Myung-Hoon
Department of Neurosurgery, Hanyang University Guri Hospital, Guri, Gyonggi-do, Korea.
Department of Neurosurgery, Hanyang University Guri Hospital, Guri, Gyonggi-do, Korea.
World Neurosurg. 2017 Dec;108:859-868.e4. doi: 10.1016/j.wneu.2017.08.076. Epub 2017 Aug 31.
Although many studies have evaluated risk factors associated with hydrocephalus after aneurysmal subarachnoid hemorrhage, specific ventricle volume changes after subarachnoid hemorrhage have not been evaluated. We sought to evaluate factors predicting ventricle volume enlargement in patients with aneurysmal subarachnoid hemorrhage by measuring ventricle volume with a validated, semiautomated tool.
Uni- and multivariable linear regression analyses were conducted with the follow-up ventricle volume as the dependent variable and the duration between subarachnoid hemorrhage occurrence and follow-up imaging as the independent variable, classified by the use of various predictive factors. A logistic regression model was used to calculate the odds ratio for the greater ventricle volume group compared with the lower ventricle volume group based on predictive factors.
We included 173 participants with a mean age of 55.5 years. Overall, an approximate increase in ventricle volume of 1.1 mL was observed daily within 60 days of clipping due to subarachnoid hemorrhage. In the multivariate logistic regression analysis, patients in the first and second tertile groups for body mass index showed approximately a 5.9- and 4.1-fold increased risk of greater follow-up ventricle volume, respectively, compared with the third tertile group for body mass index within 60 days of subarachnoid hemorrhage.
We found that greater body mass index independently predicted suppression of ventricle volume growth, owing to maintenance of subarachnoid trabeculae structures after subarachnoid hemorrhage. Further studies are needed to confirm our findings.
尽管许多研究评估了与动脉瘤性蛛网膜下腔出血后脑积水相关的危险因素，但蛛网膜下腔出血后特定脑室容积变化尚未得到评估。我们试图通过使用经过验证的半自动工具测量脑室容积，来评估预测动脉瘤性蛛网膜下腔出血患者脑室容积增大的因素。
以随访脑室容积为因变量，以蛛网膜下腔出血发生与随访成像之间的持续时间为自变量，根据各种预测因素进行分类，进行单变量和多变量线性回归分析。使用逻辑回归模型根据预测因素计算较大脑室容积组与较小脑室容积组的比值比。
我们纳入了173名平均年龄为55.5岁的参与者。总体而言，由于蛛网膜下腔出血，在夹闭后的60天内，脑室容积每天大约增加1.1 mL。在多变量逻辑回归分析中，在蛛网膜下腔出血后的60天内，体重指数处于第一和第二三分位数组的患者，与体重指数处于第三三分位数组的患者相比，随访时脑室容积较大的风险分别增加了约5.9倍和4.1倍。
我们发现较高的体重指数独立预测了脑室容积增长的抑制，这是由于蛛网膜下腔出血后蛛网膜小梁结构得以维持。需要进一步研究来证实我们的发现。
