Section of Neurosurgery, Carilion Clinic, Roanoke, Virginia, USA; Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA; School of Neuroscience, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA.
Section of Neurosurgery, Carilion Clinic, Roanoke, Virginia, USA; Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA; School of Neuroscience, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA.
World Neurosurg. 2022 Jul;163:e471-e481. doi: 10.1016/j.wneu.2022.04.007. Epub 2022 Apr 6.
The authors sought to investigate if peripheral blood leukocyte profiles on admission differed between perimesencephalic, angio-occult, and aneurysmal subarachnoid hemorrhage cohorts.
We performed a retrospective analysis of 202 consecutive patients with spontaneous subarachnoid hemorrhage. We classified spontaneous subarachnoid hemorrhage as either aneurysmal or nonaneurysmal origin. Nonaneurysmal subarachnoid hemorrhage was subclassified as either perimesencephalic or angio-occult according to the distribution of hemorrhage on the initial imaging. Patient demographics, clinical parameters, radiographic metrics, and laboratory values were obtained on admission. In-hospital data including acute hydrocephalus, shunt dependence, vasospasm, and delayed cerebral ischemia were collected. Comparative analyses were conducted between cohorts.
The perimesencephalic subarachnoid hemorrhage cohort exhibited significantly lower neutrophil (7.76 vs. 10.06; P = 0.004), lymphocyte (1.40 vs. 1.90; P = 0.024), and monocyte counts (0.52 vs. 0.73; P = 0.031) than the aneurysmal subarachnoid hemorrhage cohort. There were no significant differences in peripheral blood leukocyte profiles between the angio-occult and aneurysmal subarachnoid hemorrhage cohorts. The nonaneurysmal cohort exhibited significantly lower neutrophil (8.33 vs. 10.06; P = 0.005) and lymphocyte counts (1.47 vs. 1.90; P = 0.011) as well as a lower lymphocyte-to-monocyte ratio (2.80 vs. 4.51; P = 0.018) than the aneurysmal subarachnoid hemorrhage cohort.
Perimesencephalic subarachnoid hemorrhage exhibits a unique peripheral blood leukocyte profile compared to aneurysmal subarachnoid hemorrhage. Moreover, these preliminary data demonstrate that blood leukocytes may be affected by the burden of cisternal subarachnoid hemorrhage or the presence of a ruptured aneurysm. Further large-scale prospective studies and validation are required to confirm these preliminary findings.
作者旨在研究发病时外周血白细胞谱是否在中脑周围、隐匿性血管病变和动脉瘤性蛛网膜下腔出血亚组之间存在差异。
我们对 202 例连续自发性蛛网膜下腔出血患者进行了回顾性分析。我们将自发性蛛网膜下腔出血分为动脉瘤性或非动脉瘤性起源。根据初始影像学上出血的分布，非动脉瘤性蛛网膜下腔出血进一步分为中脑周围或隐匿性血管病变。入院时获取患者人口统计学、临床参数、影像学指标和实验室值。收集住院期间包括急性脑积水、分流依赖、血管痉挛和迟发性脑缺血等数据。对亚组间进行比较分析。
中脑周围蛛网膜下腔出血组的中性粒细胞（7.76 比 10.06；P=0.004）、淋巴细胞（1.40 比 1.90；P=0.024）和单核细胞计数（0.52 比 0.73；P=0.031）显著低于动脉瘤性蛛网膜下腔出血组。隐匿性血管病变和动脉瘤性蛛网膜下腔出血组之间的外周血白细胞谱没有显著差异。非动脉瘤性组的中性粒细胞（8.33 比 10.06；P=0.005）和淋巴细胞计数（1.47 比 1.90；P=0.011）以及淋巴细胞与单核细胞比值（2.80 比 4.51；P=0.018）显著低于动脉瘤性蛛网膜下腔出血组。
中脑周围蛛网膜下腔出血与动脉瘤性蛛网膜下腔出血相比具有独特的外周血白细胞谱。此外，这些初步数据表明，白细胞可能受脑池蛛网膜下腔出血负担或破裂动脉瘤的影响。需要进一步的大规模前瞻性研究和验证来证实这些初步发现。
