Characteristics of cerebrospinal fluid energy metabolism in subarachnoid hemorrhage patients and correlation with delayed cerebral ischemia
ZHOU Jie
WANG Huangsuo
LI Hang
LI Bo
REN Xingguang
LU Jian
Abstract：Objective To explore the features of energy metabolism in cerebrospinal fluid(CSF)in patients with subarachnoid hemorrhage(SAH)and their correlation with occurrence of delayed cerebral ischemia(DCI).Methods A total of 150 patients with aneurysmal SAH(aSAH)admitted to our department from January 2021 to May 2024 were enrolled.The CSF fluid lactate and glucose levels were monitored through external ventricular drain(EVD).Based on the occurrence of symptomatic DCI or not,they were divided a symptomatic DCI group(45 patients)and an asymptomatic DCI group(105 patients).According to clinical outcomes in 3 months later,they were also classified into a good prognosis group(56 cases)and a poor prognosis group(94 cases).Clinical data,such as gender,serum lactate and glucose levels were collected.Multivariate logistic regression analysis was employed to identify influencing factors for symptomatic DCI and poor prognosis in aSAH patients.Results The symptomatic DCD group exhibited significantly larger proportions of hypertension,World Federation of Neurosurgical Societies(WFNS)grades Ⅳ-Ⅴ and elevated CSF lactate and glucose levels,and higher serum glucose level than the asymptomatic DCD group(P<0.01).Multivariate logistic regression analysis revealed that WFNS grade,elevated CSF lactate,and increased CSF glucose were independent risk factors for symptomatic DCI in the aSAH patients(P<0.05,P<0.01).Larger proportion of WFNS grades Ⅳ-Ⅴ,elevated CSF lactate level,symptomatic DCI and increased serum glucose level were observed in the poor prognosis group than the good prognosis group(P<0.05,P<0.01).The symptomatic DCI was an independent risk factor for poor prognosis in aSAH patients(OR=11.080,95%CI:3.559-34.498,P<0.01).Conclusion WFNS grade and elevated CSF lactate/glucose levels are independent risk factors for subsequent symptomatic DCI in aSAH patients,and symptomatic DCI is an independent risk factor for poor prognosis.Monitoring CSF lactate/glucose levels may serve as a bedside test to improve the prediction for post-aSAH subacute and late-stage neurological deterioration,and to guide the adjustments for treatment plans.
Keywords：subarachnoid hemorrhagelactic acidglucosebrain ischemiaprognosis
Publication Date：2026-01-15
Online Publishing Date：2026-01-16(First online date of this platform, not the publication date of the document)
Pages：5( 70-74 )