Possibility of safe early ambulation in patients with mild aneurysmal subarachnoid hemorrhage: a retrospective cohort study

Purpose This study aimed to elucidate safety of early ambulation following aneurysmal subarachnoid hemorrhage (aSAH) onset and related factors influencing early ambulation in patients with mild aSAH.Methods A total of 150 patients were screened for eligibility. Final analysis included 62 patients with mild aSAH. The early ambulation group (n = 41) comprised patients who initiated walking training within 14 days as part of rehabilitation program, whereas the late ambulation group (n = 21) included those who initiated walking training after 14 days. Differences in baseline characteristics, rehabilitation interventions, SAH-related events, clinical outcomes, and blood test results were compared between two groups.Results The early ambulation group exhibited a significantly shorter duration of spinal drainage than the late ambulation group. The early ambulation group exhibited significantly lower hydrocephalus onset than the late ambulation group. Symptomatic cerebral vasospasm (SCV) onset and blood examination results were not significantly different between two groups.Conclusion Early ambulation within 14 days in patients with mild aSAH was not associated with life-threatening complications, including SCV and hydrocephalus. However, given retrospective design and potential time-dependent bias, a causal relationship cannot be established. Early ambulation may be considered in patients with mild aSAH after removal of spinal drain.