Risk Factors for Cognitive Impairment Following Angiographically Negative Subarachnoid Haemorrhage Around the Midbrain

Yingfeng Liu, Zhong Li, Wende Xu, Ziyu Zhao, Wei Zhang, Junlong Wu Department of Neurosurgery, The First People’s Hospital of Tianshui, Tianshui, Gansu, 741000, People’s Republic of ChinaCorrespondence: Zhong Li, Department of neurosurgery, The First People’s Hospital of Tianshui, No. 105 of Jianshe Road, Qinzhou District, Tianshui City, Gansu Province, 741000, People’s Republic of China, Tel +86-15095727988, Fax +86-0938-8218907, Email [email protected]: This study aimed to explore the risk factors for cognitive impairment caused by angiographically negative subarachnoid haemorrhage (SAH).Methods: This retrospective study employed a convenience sampling method to select patients with negative SAH in the midbrain who were admitted to the neurosurgery department of our hospital between September 2018 and September 2023. A total of 69 patients with angiographically negative SAH were enrolled and divided into the cognitive impairment group (n = 16) and the non-cognitive impairment group (n = 53). General demographic and clinical data were collected, and patients’ cognitive function was assessed using the Montreal Cognitive Assessment scale. The risk factors of the cognitive impairment caused by angiographically negative SAH were identified by logistic regression analysis.Results: The results of the univariate analysis showed that there were statistically significant differences (p < 0.05) between the two groups of patients in terms of age, consciousness disorders, history of hypertension, ventricular haemorrhage, concurrent hydrocephalus, Glasgow Coma Scale score, Hunt–Hess grading (≥ 3) and Fisher grading (≥ 3). The logistic regression results showed that age (p = 0.031), degree of consciousness impairment (p = 0.023), Hunt–Hess grading (p = 0.019), presence of hydrocephalus (p = 0.002) and presence of ventricular haemorrhage (p = 0.021) were independent risk factors for cognitive impairment after angiographically negative SAH (p < 0.05).Conclusion: Age, degree of consciousness impairment, Hunt–Hess grade (≥ 3), concomitant ventricular haemorrhage and hydrocephalus are risk factors for cognitive function after angiographically negative SAH.Keywords: subarachnoid haemorrhage, computed tomography angiography, digital subtraction angiography, cognitive impairment