Influencing factors analysis of short-term cognitive impairment after interventional embolization in the treatment of aneurysmal subarachnoid hemorrhage

ObjectiveTo discuss the influencing factors of cognitive impairment after interventional embolization in the treatment of aneurysmal subarachnoid hemorrhage(aSAH).

MethodsThe clinical data of 103 patients with aSAH were selected for retrospective analysis.All patients were divided into cognitive impairment group(37 cases) and cognitive normal group(66 cases) by using Montreal cognitive assessment(MoCA) scale to evaluate postoperative cognitive impairment 3 months after operation.The serological indexesserum neuron specific enolase(NSE), S100β, cystatin C(Cys-C), hypersensitive C reactive protein(hs-CRP), homocysteine(Hcy) within 24 hours after admission were detected and compared.Multivariate logistic regression analysis was used to explore the risk factors of cognitive impairment 3 months after interventional embolization of intracranial aneurysms in patients with aSAH.

ResultsThe age, operation time from onset, operation duration, bilateral A1 symmetrical development and new cerebral infarction in the two groups were statistically significant(P < 0.05 to P < 0.01), while sex ratio, smoking and alcohol history and other general data between the two groups was not statistically significant(P>0.05).The serum NSE, S100β, Cys-C, hs-CRP, Hcy levels of the patients in the cognitive impairment group were significantly higher than those in the cognitive normal group, while the MoCA score was significantly lower than that in the cognitive normal group(P < 0.01).Multivariate logistic regression analysis showed that the time between operation and onset, operation duration, new cerebral infarction, NSE, S100β, Cys-C, hs-CRP and Hcy were the independent risk factors of cognitive impairment after interventional embolization for aSAH(P < 0.05 to P < 0.01), while bilateral A1 symmetrical development was the independent protective factor(P < 0.01).

ConclusionsThe serum NSE, S100β, Cys-C, hs-CRP and Hcy levels of patients with cognitive impairment after interventional embolization for aSAH are significantly higher than the patients with normal cognition, and the operation time from onset, operation duration, new cerebral infarction, NSE, S100β, Cys-C Hs-CRP, Hcy are the independent risk factors for cognitive impairment after interventional embolization for aSAH, while bilateral A1 symmetrical development is the independent protective factor.