硬脑膜动静脉瘘侵袭性表现的危险因素分析

目的目前除了合并皮层静脉引流被认为是硬脑膜动静脉瘘(DAVF)的侵袭性表现的高危因素之外,尚无其他危险因素被大家所公认。本研究的目的在于通过单因素和多因素分析,阐明DAVF侵袭性表现的危险因素。方法回顾分析2007年1月至2012年12月第二军医大学长海医院临床神经医学中心收治的190例DAVF患者。其中侵袭性表现112例,非侵袭性表现78例。收集临床和影像学资料,提取人口学特征、临床表现类型、血管构筑学特征等参数,对比不同表现DAVF在上述参数上的差异,并进行Logistic回归分析。结果 Logistic回归分析发现侵袭性表现发病的独立危险因素为瘘口部位位于大静脉窦区(P0.001),引流方式为Borden II型(P0.001)和III型(P=0.002)。结论瘘口位于大静脉窦区,引流方式为Borden II型和III型是DAVF发生侵袭性表现的独立危险因素。     

手术治疗硬脑膜动静脉瘘患者预后状况的危险因素研究

目的：探讨手术治疗硬脑膜动静脉瘘患者预后危险因素。方法140例硬脑膜动静脉瘘患者分为预后良好组和预后不良组，收集其性别、年龄、瘘口位置、术前mRS、Borden分级、静脉窦血栓、手术入路方式、术后瘘口影像检查、主窦是否顺畅和术后随访等相关因素进行单因素方差分析。结果单因素方差分析显示2组间的术前m RS、静脉窦血栓、手术入路方式、术后瘘口影像检查、主窦是否顺畅的差异具有统计学意义（P＜0·05），而性别、年龄、瘘口位置以及Borden分级的差异无统计学意义（P＞0·05）。结论术前神经功能损伤严重、联合入路手术方式、瘘口部分消除合并皮质静脉引流以及主窦不顺畅是影响硬脑膜动静脉瘘患者预后的独立危险因素。     

神经内镜经鼻蝶切除垂体腺瘤患者脑脊液漏的影响因素分析

目的探讨影响垂体腺瘤患者在神经内镜下经鼻蝶入路手术中及手术后发生脑脊液漏的影响因素。方法回顾性分析中南大学湘雅二医院神经外科2011年1月至2017年6月连续收治的112例垂体腺瘤患者的临床资料,对所有患者均行神经内镜经鼻蝶入路手术。采用单因素和多因素Logistic回归方法分析影响患者术中、术后早期（术后≤7d）和术后晚期（术后〉7d）出现脑脊液漏的因素。结果112例患者中,33．0％（37／112）的患者术中出现脑脊液漏,9．8％（11／112）术后早期出现脑脊液漏,6．3％（7／112）术后晚期出现脑脊液漏。单因素和多因素分析结果显示肿瘤直径（OR=1．090,95％CI=1．027～1．156,P=0．004）是影响患者术中出现脑脊液漏的危险因素;麻醉分级（OR=4．920,95％CI：1．360～17．808,P=0．015）是影响患者术后早期出现脑脊液漏的危险因素,而带血管蒂皮瓣修补（OR=0．100,95％CI=0．012～0．841,P=0．034）是其保护因素;慢性呼吸系统疾病（OR=68．667,95％CI：8．848～532．925,P〈0．001）是影响患者术后晚期出现脑脊液漏的危险因素。结论神经内镜经鼻蝶入路切除垂体腺瘤,肿瘤体积越大,越易发生术中脑脊液漏;麻醉分级越高,越易发生术后早期脑脊液漏,带血管蒂黏膜瓣修补能使术后早期脑脊液漏的危险性降低;有慢性呼吸道疾病的患者易发生术后晚期脑脊液漏。     

Koos3、4级听神经瘤术后面神经功能的影响因素分析

目的探讨影响Koos3、4级（大中型）听神经瘤术后面神经功能的相关因素。方法回顾性纳入2013年6月至2016年5月天津医科大学总医院神经外科收治的72例Koos3、4级听神经瘤的患者。术后随访1—2年,根据术后1年面神经功能House—Brackmann（H—B）分级标准分为A组（H-B分级I～Ⅱ级）和B组（H—B分级Ⅲ～Ⅵ级）,评价其面神经功能,并分析其影响因素。结果72例患者中,术后1年面神经功能H—B分级Ⅰ～Ⅱ级（A组）53例,H—B分级Ⅲ～Ⅵ级（B组）19例,两组患者的肿瘤直径、囊变情况、面神经空间位置类型比较差异均有统计学意义（均P〈0．05）。Logistic多元回归分析表明：肿瘤直径（OR=2．538,95％CI：1．231～5．231;P=0．012）、肿瘤囊变（OR=6．209,95％CI：1．635～23．582;P=0．007）及面神经空间位置（3型对比1型：OR=6．103,95％CI：1．218—30．586;P=0．028）与Koos3、4级听神经瘤术后面神经功能相关（r=0．499,P〈0．05）;肿瘤直径相对较小、无囊变和面神经位于肿瘤前方（1型）者术后面神经功能恢复更好。结论肿瘤直径、囊性变及面神经空间位置类型是影响Koos3、4级（大中型）听神经瘤术后面神经功能的重要因素。精准的术前评估有益于面神经功能的保护与恢复。     

脑血栓形成复发的危险因素研究

目的：探讨脑血栓形成复发的危险因素。方法：收集首发441例脑血栓形成患者的临床资料,采用前瞻性队列研究,随访1年,记录终点事件。结果：脑血栓形成1年复发率为t3．8％;年龄（P=0．002,OR=1．044,95％CI=1．015～1．073）、高血压病史（P=0．040,OR=I．944,95％CI=1．032～3．663）、纤维蛋白原（P=0．000,OR=I．932,95％CI=1．386～2．666）为影响脑血栓形成复发的因素。结论：高龄、高血压病史及纤维蛋白原升高是脑血栓形成复发的重要危险因素。     

开放性颅脑创伤早期癫痫发作危险因素分析

目的探讨开放性颅脑创伤后早期癫痫发作危险因素,并提出初步预防措施。方法对2006年9月-2009年9月诊断与治疗的91例开放性颅脑创伤患者的临床资料进行单因素及多因素Logistic逐步回归分析,筛选颅脑创伤后早期癫痫发作之危险因素。结果单因素分析显示,年龄（X^2=5．131,P=0．023）、颅脑创伤分型（X^2=6．302,P=0．043）、损伤部位（X^2=12．800,P=0．046）,以及伴发脑挫裂伤（X^2=7．187,P=0．007）、外伤性蛛网膜下隙出血（X^2=11．092,P=0．001）、颅内血肿（X^2=6．555,P=0．010）和凹陷性骨折（X^2=8．463,P=0．043）等项因素与开放性颅脑创伤后早期癫痼发作显著相关。进一步Logistie逐步回归分析,仅年龄（OR=7．719,95％CI=1．129。52．777;P=0．037）、脑挫裂伤（OR=28．590,95％CI=2．241．364．734;P=0．010）、外伤性蛛网膜下隙出血（OR=8．244,95％CI=1．259。53．706;P=O．028）和颅内血肿（OR=24．344,95％CI=2．415．345．395;P=0．007）为危险因素,且以脑挫裂伤危险度相对较高;而与颅脑创伤分型、损伤部位及凹陷性骨折无关。结论开放性颅脑创伤后早期癫痼发作应及时治疗,对合并危险因素的患者应早期给予预防性抗癫痫药物治疗。     

Fisher Ⅲ-Ⅳ级颅内动脉瘤并发脑积水的影响因素分析

目的 探讨FisherⅢ-Ⅳ级颅内动脉瘤性蛛网膜下腔出血患者并脑积水的相关危险因素。方法 纳入宁夏医科大学总医院神经外科2015年5月—2022年1月收治的313例破裂颅内动脉瘤性蛛网膜下腔出血FisherⅢ-Ⅳ患者,根据不同治疗方式,分别比较并发脑积水和非脑积水2组患者的临床数据资料,经多因素Logistic回归分析患者发生脑积水的独立危险因素。通过独立危险因素构建预测模型,结合受试者工作特征(ROC)曲线,分析模型对患者并发脑积水的预测价值。结果 经单因素分析出开颅夹闭和血管内患者术后合并脑积水分别与FisherⅣ级(P=0.004)、持续腰大池引流(LD)(P=0.017)和Hunt-HessⅢ-V级(P=0.003)、FisherⅣ级(P=0.005)、去骨瓣减压术(P=0.042)、肺炎(P=0.016)相关。经多因素分析得出,开颅夹闭后并脑积水发生的独立危险因素为FisherⅣ级[P=0.007,优势比(OR)=17.949,OR 95%置信区间(CI):2.181～147.682],LD(P=0.003,OR=4.717,OR 95%CI:1.486～89.027)。RO...     

急性缺血性卒中重组组织型纤溶酶原激活剂静脉溶栓致出血性转化及其预后的危险因素分析

目的 探讨急性缺血性卒中重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓后发生出血性转化(HT)的可能危险因素以及这些危险因素对患者预后的影响.方法 128例急性缺血性卒中患者发病6h内接受rt-PA静脉溶栓治疗,选取溶栓前临床和实验室资料,通过比较HT组与非HT组之间的差异,筛选与HT相关的可能危险因素,并进一步通过Logistic回归分析影响HT及其预后的独立危险因素.结果 128例溶栓患者有29例继发HT(22.66％),其中16例为症状性脑出血(12.50％),死亡2例,占HT的6.90％.Logistic回归分析表明房颤(OR=1.293,95％ CIl.224 ～1.589,P=0.00l)、早期CT改变(OR=2.452,95％ CI 1.132～3.309,P=0.034)、基线舒张压≥100 mm Hg(1 mm Hg=0.133 kPa,OR=9.265,95％ CI 1.435 ～ 59.836,P=0.019)、基线血糖≥11.1 mmol/L(OR=3.037,95％ CI0.252 ～ 57.593,P=0.047)、NIHSS评分＞15分(OR=8.752,95％CI 1.035 ～30.285,P=0.023)和溶栓时间窗＞3h(OR=98.74,95％CI 5.067 ～ 186.120,P=0.002)6项为HT独立危险因素,其中基线血糖≥11.1 mmol/L(OR=3.265,95％ CI 0.435 ～ 59.863,P=0.045)、NIHSS评分＞15分(OR=10.453,95％ CI 5.647～38.185,P=0.003)和溶栓时间窗＞3h(OR =2.541,95％CI 1.098 ～51.086,P=0.017)影响了HT患者的预后.结论 溶栓前的舒张压、血糖水平、神经功能缺损程度、CT低密度改变或水肿占位效应、房颤和溶栓时间窗是HT的独立危险因素,其中基线血糖水平、神经功能缺损程度和溶栓时间窗影响了溶栓后HT患者的预后.     

难治性癫痫早期预测因素的病例对照研究

目的 探索癫痫患者易演变为难治性癫痫（refractory epilepsy,RE）的早期预测因素,为临床尽早处理RE提供理论依据。方法 收集173例诊断明确、治疗合理的癫痫患者,分为药物难治性癫痫(drug non-responsive epilepsy,DNR-EP)组（106例）和药物有效性癫痫(drug-responsiveepilepsy,DR-EP)组（67例）。通过观察癫痫患者早期临床特点,采用多因素Logistic回归分析,探索癫痫患者易发展为RE的预测因素。结果 多因素Logistic回归分析显示：初次治疗前＞10次发作（OR =4.46,95％ CI 1.60～12.40,P=0.004）、早期伴智能障碍(OR=19.87,95％ CI 3.60～ 109.78,P=0.001)、治疗后脑电图仍有癫痫波样异常（OR=7.57,95％ CI 2.54～22.56,P＜0.01）是癫痫患者易发展为RE的预测因素;而初次使用抗癫痫药物(AEDs)治疗效果良好是RE的保护因素（OR=0.05,95％ CI 0.018 ～0.139,P＜0.01）。结论 初次治疗前发作次数多、早期伴智能障碍、治疗后脑电图仍有癫痫波样异常、初次AEDs治疗效果差的癫痫患者易发展为RE。     

急性脑卒中患者营养不良、卒中后并发症及不良预后的危险因素分析

目的 探讨影响急性脑卒中患者营养不良、卒中后并发症及不良预后的危险因素.方法 收集122例急性脑卒中患者的一般资料,进行营养状况和神经功能缺损程度评估.3个月后采用改良Rankin量表(mRS)评估预后.分析各因素与急性脑卒中患者营养不良、卒中后并发症及不良预后的关系.结果 随访结束时,共91例患者纳入本次研究.年龄及NIHSS评分为入院时营养不良的危险因素(P＜ 0.05～0.001);年龄、高胆固醇血症、入院营养不良、鼻饲为7d时营养不良的危险因素(P＜0.05 ～0.001).多因素Logistic回归分析显示,入院营养不良为7d发生营养不良的独立预测因素(OR=14.15,95％CI:3.32～61.76,P＜0.001).年龄、入院NIHSS评分、入院营养不良、鼻饲、7d时NIHSS评分、7d时营养不良及营养状况恶化为发生并发症的危险因素(均P＜0.01).多因素Logistic回归分析显示,入院NIHSS评分及入院营养不良为并发症的独立预测因素(OR=1.11,95％CI:1.04 ～ 1.48,P＜0.05;OR=6.56,95％CI:1.18 ～42.72,P＜0.05).年龄、入院NIHSS评分、7d时NIHSS评分、7d时营养不良及营养状况恶化为预后不良的危险因素(P ＜0.05 ～0.01).多因素Logistic回归分析显示,7d时营养不良及7d时NIHSS评分为预后不良的独立预测因素(OR =-4.32,95％CI:1.15 ～ 18.89,P＜0.05;OR=1.81,95％CI:1.21 ～2.43,P＜0.01).结论 入院营养不良为7d发生营养不良的独立危险因素,入院NIHSS评分及营养不良为并发症的独立危险因素,7d时营养不良及NIHSS评分为预后不良的独立危险因素.     

Incidence of hereditary thrombophilia in patients with cranial dural arteriovenous fistulae

Dural arteriovenous fistulas (DAVFs) can develop as consequence of prior venous sinus thrombosis. However, the prevalence of prothrombotic conditions in patients with intracranial DAVFs is unknown and there is no consensus on the indications to screen for procoagulable conditions in these patients. We performed a retrospective review of patients presenting to our institution for management of cranial DAVF. Patient and DAVF characteristics were noted, in particular the incidence of hereditary thrombophilia (HT) detected by laboratory evaluation. Respective comparisons of patients with and without HT were performed using comparative statistics. There were 165 patients presenting for management of 171 DAVFs. A large proportion of DAVF were located at a large dural sinus (42.7%), which included superior sagittal, transverse, and sigmoid sinuses. On multivariate logistic regression analysis cortical venous drainage was independently associated with hemorrhagic presentation (OR 8.23, 95% CI 1.78–38.08; p = 0.007). A HT was detected in 18 of 61 patients (29.5%) who underwent a thrombophilia work-up. Location at a large dural sinus was not more common in patients with a HT (55.0% vs 54.5%; p = 0.97). There was also no difference in the presence of cortical venous drainage (56.5% vs 38.6%; p = 0.22) or hemorrhage on presentation (15.9% vs 5.0%; p = 0.22) in patients with and without a HT. In HT were found to be highly prevalent in our cohort, though our results do not suggest their presence greatly influences DAVF pathophysiology. Screening for procoagulable states is indicated in selected patients with an intracranial DAVF.     

Clinical characteristics of dural arteriovenous fistula.

Intracranial dural arteriovenous fistula (DAVF) is an uncommon neurosurgical condition; in particular, it has been infrequently reported in Korea. To understand the general clinical characteristics of DAVFs, the authors reviewed 53 cases and analyzed factors affecting DAVF hemorrhage of and treatment outcome. Since 1980 we have encountered 480 pial and 53 DAVFs, a ratio of 9.1 to 1. The age of these patients ranged from 1 month to 71 years, the most common being in the 6th decade, and females exceeded males by 1.65 to 1. All lesions except three were single, and symptoms were related to location and the venous drainage pattern. The most common location was the cavernous sinus, accounting for about 64% of cases, with the result that the most common clinical symptoms of DAVFs were ocular, namely proptosis and chemosis. The next was tinnitus also found in transverse-sigmoid sinus DAVFs. Intracranial hemorrhage was seen in eight cases,(15%) the primary cause of hemorrhage was retrograde intracranial venous drainage (P=0.017), and one hemorrhage was observed in cases with no intracranial venous drainage. Intracranial hemorrhage was more frequently in transverse-sigmoid than cavernous sinus DAVFs (P=0.049), and this proved to be so even where there was intracranial venous drainage. However, two of 34 patients with cavernous DAVFs became blind in one eye, demonstrating that in such patients, the clinical course could be aggressive. Thirteen patients were treated conservatively. The conservative treatment group was comprised of 13 patients, two of three patients with transverse-sigmoid sinus DAVF expired, and 7 of 10 with cavernous sinus DAVF experienced a clinical improvement or cure. Surgical excision was performed in only two patients. A total of 39 patients underwent embolization; clinical cure was achieved in 13, improvement of symptoms in 12, an unchanged or aggravated result occurred in 9, one died, and four were lost to follow up. During intervention, there was one hemorrhagic complication, owing to obstruction of the venous outflow with embolic materials.In this study, the most common location of DAVFs was the cavernous sinus. The cortical venous drainage remains the primary determinant of intracranial hemorrhage. Common indications for treatment include hemorrhage and neurological deficit. Endovascular treatment is preferred in the majority of cases except tentorial DAVF. The goal of embolization in cavernous DAVF is the alleviation of symptoms, not angiographic cure. But transverse-sigmoid sinus DAVF with venous restriction and leptomeningeal drainage should be treated aggressively.     

颅内囊性动脉瘤破裂形态学的危险因素分析

目的研究颅内囊性动脉瘤破裂的形态学危险因素。方法回顾性分析551例（共611个）颅内囊性动脉瘤的病例资料,以动脉瘤破裂作为最后评定指标,分为破裂组（341个动脉瘤）和未破裂组（270个动脉瘤）,使用SPSS17.0统计软件包分析数据。结果两组之间动脉瘤长、瘤颈宽、载瘤动脉平均直径、载瘤动脉近端与动脉瘤长轴夹角（IA）、瘤体长与瘤颈宽之比（AR）、瘤体最大径与载瘤动脉平均直径之比（SR）、动脉瘤面积与瘤颈处动脉面积之比（S1/S2）、存在子瘤有显著差异（P〈0.05）。多因素Logistic回归分析显示：瘤颈宽〈1.7 mm（OR=2.318,95%CI=1.381-3.893,P=0.001）、存在子瘤（OR=12.512,95%CI=7.827-20.002,P〈0.001）、S1/S2〉2.1（OR=2.460,95%CI=1.408-4.300,P=0.002）为颅内囊性动脉瘤破裂的独立危险因素。结论动脉瘤长、瘤颈宽、载瘤动脉平均直径、IA、AR、SR、S1/S2、存在子瘤是动脉瘤破裂的形态学危险因素。     

垂体腺瘤经鼻蝶入路神经内镜切除术后颅内感染的危险因素

目的 探讨垂体腺瘤经鼻蝶入路神经内镜切除术后发生颅内感染的危险因素。方法 回顾性分析2016年12月至2020年10月间经鼻蝶入路神经内镜手术切除的652例垂体腺瘤的临床资料,采用多因素logistic回归模型分析术后发生颅内感染的危险因素。结果 652例中,20例术后发生颅内感染,发生率为3.07%。多因素logistic回归分析显示,CSF漏(OR=5.845; 95% CI 1.334~25.613; P=0.019)、腰大池引流（OR=8.382;95% CI 1.807~38.874;P=0.007）、肿瘤直径>2 cm（OR=11.797;95% CI 1.395~99.727;P=0.023）、手术时间>3 h（OR=4.286;95% CI 1.005~18.279;P=0.049）、多次手术（OR=10.127;95% CI 1.334~25.613;P=0.019）、术后使用激素（OR=4.518;95% CI 1.301~15.686;P=0.018）是术后发生颅内感染的独立危险因素。结论 PA病人术后发生颅内感染,严重影响病人预后和手术效果;早期识别颅内感染的危险因素,采取适当的预防措施,对减少PA病人经鼻蝶入路神经内镜切除术后颅内感染,尤为重要。     

脑积水脑室穿刺术后继发导管相关性出血的危险因素

目的 探讨脑积水脑室穿刺术后继发导管相关性出血的危险因素。方法 回顾性分析2015年4月至2020年7月收治的187例脑积水的临床资料。结果 187例中,120例经枕角穿刺行脑室-腹腔分流术,67例经额角穿刺行脑室外引流术。术后发生导管相关性出血13例,发生率为 6.9%;其中枕角穿刺出血7例,额角穿刺出血6例;保守治疗2例,手术治疗11例;出院时GOS评分4~5分7例,2~3分4例,1分2例;出院后随访6个月,GOS评分无明显变化。多因素logistic回归分析显示,颅内压急剧下降（OR=6.39;95% CI 1.67~24.5;P=0.007）、堵管后重新置管（OR=5.45;95% CI 1.45~20.4;P=0.010）、脑室穿刺>3次（OR=10.4;95% CI 2.33~46.6;P=0.002）是导管相关性出血的独立危险因素。结论 导管相关性出血是脑积水脑室穿刺术后较为少见的、严重并发症,围手术期应综合评估,以降低术后出血概率;术后应密切观察病情并及时复查头颅CT,出血量大的病人,预后较差。     

青年烟雾病患者的卒中类型及危险因素分析

目的 探索青年烟雾病患者的卒中类型及临床特征,分析青年烟雾病患者发生卒中的危险因素。 方法 回顾性纳入2020年1月-2021年12月解放军总医院第五医学中心收治的青年（18～45岁）卒中型烟雾病患者,将患者分为出血性卒中组和缺血性卒中组进行亚型分析,对比不同卒中类型患者的临床及影像学特征。并以同期未发生卒中的烟雾病患者作为对照组,应用多因素logistic回归分析青年烟雾病患者发生出血性或缺血性卒中的危险因素。 结果 共入组108例卒中型烟雾病患者,其中出血性卒中22例（20.4%）,缺血性卒中86例（79.6%）。出血性卒中组中脑室出血12例（54.5%）,脑实质出血7例（31.8%）,蛛网膜下腔出血3例（13.6%）。缺血性卒中组中大动脉梗死型21例（24.4%）,血流动力学梗死36例（41.9%）,穿支动脉梗死29例（33.7%）。出血性卒中组与缺血性卒中组性别和合并动脉瘤者比例的差异有统计学意义。无卒中对照组共104例,多因素logistic回归分析结果显示,合并动脉瘤（OR?10.569,95%CI?1.524～73.274,P=0.017）为青年烟雾病患者发生出血性卒中的独立危险因素;增龄（OR?1.058,95%CI?1.004～1.115,P=0.034）、合并糖尿病（OR?4.005,95%CI?1.766～9.080,P=0.001）、高铃木分期（OR?1.363,95%CI 1.037～1.793,P=0.027）为青年烟雾病患者发生缺血性卒中的独立危险因素。 结论 青年烟雾病患者的卒中类型以缺血性卒中为主。血流动力学梗死和脑室出血分别是缺血性卒中和出血性卒中的主要类型。增龄、高铃木分期、合并糖尿病和颅内动脉瘤是引起青年烟雾病患者卒中的独立危险因素。     

Risk factors for multiple intracranial aneurysms

BACKGROUND AND PURPOSE: The presence of multiple intracranial aneurysms may be a sign of significant risk factors for aneurysm formation that differ from those factors that increase risk for aneurysm rupture. Only 2 studies concern independent risk factors for multiple aneurysms, and the results are in part controversial. This study was designed to identify independent risk factors for multiple intracranial aneurysms in patients with subarachnoid hemorrhage. METHODS: Of 266 patients with aneurysmal subarachnoid hemorrhage (139 men and 127 women, aged 15 to 60 years), 80 (30%) had multiple intracranial aneurysms. The prevalence of several health-related habits, previous diseases, and medications of these patients were compared by multiple logistic regression between those with single and those with multiple aneurysms. RESULTS: On the basis of multivariate statistics, only regular cigarette smoking at any time was a significant risk factor for the presence of multiple aneurysms. The odds ratio (OR) of smoking for multiple aneurysms was 2.10 (95% CI, 1.06 to 4.13) after adjustment for age and sex. After additional adjustment for hypertension, the risk was 2.06 (95% CI, 1. 04 to 4.07). Of other variables, only age (OR, 1.02 per year; 95% CI, 1.00 to 1.05; P=0.09) and female sex (OR, 1.60; 95% CI, 0.90 to 2. 85; P=0.11) showed a tendency to increase the risk for multiple aneurysms after adjustment for smoking. On the other hand, patients with hypertension had significantly (P=0.029) more aneurysms (1. 61+/-1.04) than did those without (1.37+/-0.68), although they did not more frequently have multiple aneurysms. CONCLUSIONS: Cigarette smoking and possibly also age and female sex seem to be risk factors for multiple intracranial aneurysms in patients of working age who have suffered a subarachnoid hemorrhage. Patients with hypertension seem to have more aneurysms than those without.     

血管内治疗颅内动脉瘤术后发生急性脑积水的危险因素及处理

目的 可能危险因素进行Logistic多元回归分析.结果 Hunt-Hess分级和早期腰池持续置管引流为颅内动脉瘤血管内介入治疗后并发急性脑积水的最重要影响因素.结论 颅内动脉瘤血管内介入治疗后早期选择腰大池蛛网膜下腔持续引流,可预防急性脑积水发生,该方法可避免脑室穿刺,起到治疗急性脑积水的作用.