Risk factors for trapped temporal horn formation during the treatment of central nervous system infections in neurosurgical patients

To investigate the potential risk factors associated with the formation of trapped temporal horn (TTH) during the treatment of central nervous system (CNS) infections in neurosurgical patients. A total of 150 patients with CNS infections secondary to neurosurgical conditions, treated in the Department of Cerebrospinal Fluid Surgery at Aviation General Hospital between January 2020 and January 2024, were retrospectively enrolled. Based on the presence or absence of TTH, patients were divided into two groups: the TTH group (n = 36) and the non-TTH group (n = 114). Additionally, patients were categorized into two subgroups based on the presence of purulent CSF: the purulent CSF group (n = 35) and the non-purulent CSF group (n = 115). Data from clinical records, laboratory results, and imaging studies were analyzed. Univariate and multivariate logistic regression analyses were performed to identify risk factors associated with TTH formation. Key clinical and laboratory variables, including CSF white blood cell (WBC) count, red blood cell (RBC) count, polymorphonuclear cell percentage, protein content, glucose levels, and pathogen type, were considered as potential risk factors for TTH formation. The incidence of TTH formation was 24.0% (36/150). Univariate analysis revealed that CSF white blood cell count, CSF red blood cell count, CSF polymorphonuclear cell percentage, CSF protein content, CSF glucose level, Gram-negative bacilli as the causative pathogen, and purulent CSF were significantly associated with TTH formation (P < 0.05). Multivariate logistic regression analysis demonstrated that elevated CSF red blood cell count, purulent CSF, and Gram-negative bacilli infection were independent risk factors for TTH formation (P < 0.05). Additionally, patients with purulent CSF or Gram-negative infection experienced poorer neurological outcomes, including slower recovery in cognitive and motor functions, and a higher incidence of complications, such as persistent inflammation (P < 0.05). CNS infections caused by Gram-negative bacilli are more likely to produce purulent CSF. Significantly elevated CSF red blood cell count, purulent CSF, and Gram-negative bacterial infection are significantly and positively correlated with the development of TTH following CNS infections.