Morphometric Study of the Initial Ventricular Indices to Predict the Complications and Outcome of Aneurysmal Subarachnoid Hemorrhage
Objective: Acute hydrocephalus is a common complication in patients with aneurysmal subarachnoid hemorrhage (SAH). Several ventricular indices have been introduced to enable measurements of ventricular morphology. Previously, researchers have showed their diagnostic value for various neurological di...
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| Format: | Article |
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MDPI AG
2023-03-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/7/2585 |
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| author | Maryam Said Meltem Gümüs Jan Rodemerk Mehdi Chihi Laurèl Rauschenbach Thiemo F. Dinger Marvin Darkwah Oppong Yahya Ahmadipour Philipp Dammann Karsten H. Wrede Ulrich Sure Ramazan Jabbarli |
| author_facet | Maryam Said Meltem Gümüs Jan Rodemerk Mehdi Chihi Laurèl Rauschenbach Thiemo F. Dinger Marvin Darkwah Oppong Yahya Ahmadipour Philipp Dammann Karsten H. Wrede Ulrich Sure Ramazan Jabbarli |
| author_sort | Maryam Said |
| collection | DOAJ |
| description | Objective: Acute hydrocephalus is a common complication in patients with aneurysmal subarachnoid hemorrhage (SAH). Several ventricular indices have been introduced to enable measurements of ventricular morphology. Previously, researchers have showed their diagnostic value for various neurological disorders. In this study, we evaluated the association between ventricular indices and the clinical course, occurrence of complications and outcome of SAH. Methods: A total of 745 SAH patients with available early admission computed tomography scans were included in the analyses. Six ventricular indices (bifrontal, bicaudate, ventricular and third ventricle ratios and Evans’ and Huckman’s indices) were measured. Primary endpoints included the occurrence of cerebral infarctions, in-hospital mortality and a poor outcome at 6 months. Secondary endpoints included different adverse events in the course of SAH. Clinically relevant cut-offs for the indices were determined using receiver operating curves. Univariate analyses were performed. Multivariate analyses were conducted on significant findings in a stepwise backward regression model. Results: The higher the values of the ventricular indices were and the older the patient was, the higher the WFNS and Fisher’s scores were, and the lower the SEBES score was at admission. Patients with larger ventricles showed a shorter duration of intracranial pressure increase > 20 mmHg and required decompressive craniectomy less frequently. Ventricular indices were independently associated with the parameters of inflammatory response after SAH (C-reactive protein in serum and interleukin-6 in cerebrospinal fluid and fever). Finally, there were independent correlations between larger ventricles and all the primary endpoints. Conclusions: The lower risk of intracranial pressure increase and absence of an association with vasospasm or systemic infections during SAH, and the poorer outcome in individuals with larger ventricles might be related to a more pronounced neuroinflammatory response after aneurysmal bleeding. These observations might be helpful in the development of specific medical and surgical treatment strategies for SAH patients depending on the initial ventricle measurements. |
| first_indexed | 2024-03-11T05:32:58Z |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T05:32:58Z |
| publishDate | 2023-03-01 |
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| spelling | doaj.art-931e321ac91e40babf3ddc1f3ae370262023-11-17T16:59:08ZengMDPI AGJournal of Clinical Medicine2077-03832023-03-01127258510.3390/jcm12072585Morphometric Study of the Initial Ventricular Indices to Predict the Complications and Outcome of Aneurysmal Subarachnoid HemorrhageMaryam Said0Meltem Gümüs1Jan Rodemerk2Mehdi Chihi3Laurèl Rauschenbach4Thiemo F. Dinger5Marvin Darkwah Oppong6Yahya Ahmadipour7Philipp Dammann8Karsten H. Wrede9Ulrich Sure10Ramazan Jabbarli11Department of Neurosurgery and Spine Surgery, University Hospital of Essen, 45147 Essen, GermanyDepartment of Neurosurgery and Spine Surgery, University Hospital of Essen, 45147 Essen, GermanyDepartment of Neurosurgery and Spine Surgery, University Hospital of Essen, 45147 Essen, GermanyDepartment of Neurosurgery and Spine Surgery, University Hospital of Essen, 45147 Essen, GermanyDepartment of Neurosurgery and Spine Surgery, University Hospital of Essen, 45147 Essen, GermanyDepartment of Neurosurgery and Spine Surgery, University Hospital of Essen, 45147 Essen, GermanyDepartment of Neurosurgery and Spine Surgery, University Hospital of Essen, 45147 Essen, GermanyDepartment of Neurosurgery and Spine Surgery, University Hospital of Essen, 45147 Essen, GermanyDepartment of Neurosurgery and Spine Surgery, University Hospital of Essen, 45147 Essen, GermanyDepartment of Neurosurgery and Spine Surgery, University Hospital of Essen, 45147 Essen, GermanyDepartment of Neurosurgery and Spine Surgery, University Hospital of Essen, 45147 Essen, GermanyDepartment of Neurosurgery and Spine Surgery, University Hospital of Essen, 45147 Essen, GermanyObjective: Acute hydrocephalus is a common complication in patients with aneurysmal subarachnoid hemorrhage (SAH). Several ventricular indices have been introduced to enable measurements of ventricular morphology. Previously, researchers have showed their diagnostic value for various neurological disorders. In this study, we evaluated the association between ventricular indices and the clinical course, occurrence of complications and outcome of SAH. Methods: A total of 745 SAH patients with available early admission computed tomography scans were included in the analyses. Six ventricular indices (bifrontal, bicaudate, ventricular and third ventricle ratios and Evans’ and Huckman’s indices) were measured. Primary endpoints included the occurrence of cerebral infarctions, in-hospital mortality and a poor outcome at 6 months. Secondary endpoints included different adverse events in the course of SAH. Clinically relevant cut-offs for the indices were determined using receiver operating curves. Univariate analyses were performed. Multivariate analyses were conducted on significant findings in a stepwise backward regression model. Results: The higher the values of the ventricular indices were and the older the patient was, the higher the WFNS and Fisher’s scores were, and the lower the SEBES score was at admission. Patients with larger ventricles showed a shorter duration of intracranial pressure increase > 20 mmHg and required decompressive craniectomy less frequently. Ventricular indices were independently associated with the parameters of inflammatory response after SAH (C-reactive protein in serum and interleukin-6 in cerebrospinal fluid and fever). Finally, there were independent correlations between larger ventricles and all the primary endpoints. Conclusions: The lower risk of intracranial pressure increase and absence of an association with vasospasm or systemic infections during SAH, and the poorer outcome in individuals with larger ventricles might be related to a more pronounced neuroinflammatory response after aneurysmal bleeding. These observations might be helpful in the development of specific medical and surgical treatment strategies for SAH patients depending on the initial ventricle measurements.https://www.mdpi.com/2077-0383/12/7/2585subarachnoid hemorrhageventricular measurementsinflammationmarkerdecompressive craniectomy |
| spellingShingle | Maryam Said Meltem Gümüs Jan Rodemerk Mehdi Chihi Laurèl Rauschenbach Thiemo F. Dinger Marvin Darkwah Oppong Yahya Ahmadipour Philipp Dammann Karsten H. Wrede Ulrich Sure Ramazan Jabbarli Morphometric Study of the Initial Ventricular Indices to Predict the Complications and Outcome of Aneurysmal Subarachnoid Hemorrhage Journal of Clinical Medicine subarachnoid hemorrhage ventricular measurements inflammation marker decompressive craniectomy |
| title | Morphometric Study of the Initial Ventricular Indices to Predict the Complications and Outcome of Aneurysmal Subarachnoid Hemorrhage |
| title_full | Morphometric Study of the Initial Ventricular Indices to Predict the Complications and Outcome of Aneurysmal Subarachnoid Hemorrhage |
| title_fullStr | Morphometric Study of the Initial Ventricular Indices to Predict the Complications and Outcome of Aneurysmal Subarachnoid Hemorrhage |
| title_full_unstemmed | Morphometric Study of the Initial Ventricular Indices to Predict the Complications and Outcome of Aneurysmal Subarachnoid Hemorrhage |
| title_short | Morphometric Study of the Initial Ventricular Indices to Predict the Complications and Outcome of Aneurysmal Subarachnoid Hemorrhage |
| title_sort | morphometric study of the initial ventricular indices to predict the complications and outcome of aneurysmal subarachnoid hemorrhage |
| topic | subarachnoid hemorrhage ventricular measurements inflammation marker decompressive craniectomy |
| url | https://www.mdpi.com/2077-0383/12/7/2585 |
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