Longitudinal analysis of blood-brain barrier status and correlation with neurological outcomes in patients with subarachnoid hemorrhage
WANG Xuehong
SONG Tianyu
ZHANG Heng
CAO Chengfeng
Abstract：Objective To investigate the longitudinal changes in blood-brain barrier(BBB)status and their correlation with neurological outcomes in patients with subarachnoid hemorrhage(SAH).Methods A retrospective study was conducted on 180 SAH patients admitted to our department from January 2020 to January 2025.According to whether the patients developed delayed cerebral ischemia(DCI),they were divided into a DCI group(49 cases)and a non-DCI group(131 cases).Based on the modified Rankin scale(mRS)scores at 3 months after treatment,they were also assigned into a good prognosis group(123 cases)and a poor prognosis group(57 cases).The volume transfer constant,Ktrans,at admission and during the DCI time window was collected and compared.Multivariate logistic regression analysis was used to identify independent predictors of DCI occurrence and poor functional outcomes.Results The DCI group exhibited significantly more advanced age,and larger proportions of Hunt-Hess(H-H)grade Ⅲ,World Federation of Neurological Surgeons(WFNS)grade Ⅲ and modified Fisher scale(mFS)grade Ⅲ(P＜0.05,P＜0.01),and higher Ktrans values at admission and during the DCI time window(P＜0.05,P＜0.01)when compared with the non-DCI group.And with the extension of time,the Ktrans values were decreased obviously in both groups(P＜0.05).Multivariate logistic regression analysis showed that age(OR=1.170,95％CI:1.028-1.332,P＜0.05),Ktrans value at admission(OR=75.491,95％CI:4.099-1390.262,P＜0.01),H-H grade(OR=2.275,95％CI:1.063-4.872,P＜0.05)and WFNS grade(OR=2.305,95％CI:1.107-4.798,P＜0.05)were all independent risk factors for DCI in SAH patients.Advanced age and higher proportions of H-H grade Ⅲ,WFNS grade Ⅲ,mFS grade Ⅲ and DCI were observed in the poor prognosis group than the good prognosis group(P＜0.01).Multivariate logistic regression analysis indicated that age(OR=1.881,95％CI:1.476-2.398,P＜0.01),Ktrans value during the DCI time window(OR=111.804,95％CI:1.787-6993.622,P＜0.05),mFS grade(OR=6.256,95％CI:2.341-16.718,P＜0.01)and DCI(OR=5.057,95％CI:1.789-14.294,P＜0.01)were all independent risk factors for poor prognosis in SAH patients.Conclusion An elevated Ktrans at admission is associated with the occurrence of DCI in SAH patients.Continuous monitoring of Ktrans from admission to the DCI time window can predict neurological outcomes at 3 months after treatment.
Keywords：subarachnoid hemorrhageblood-brain barrierbrain ischemianeurological function
Publication Date：2026-03-15
Online Publishing Date：2026-03-31(First online date of this platform, not the publication date of the document)
Pages：5( 348-352 )