The level of lactate in the subcavity of the cobweb film predicted the occurrence of hydrocephalus after aSAH.

Shunt-dependent hydrocephalus is a common complication of aneurysm-based cobweb subcavity bleeding (aSAH), with an incidence rate of about 6%-67%.
hydrocephalus can significantly affect the long-term survival rate of aSAH patients.
related factors associated with the occurrence of hydrocephalus, including age 50 years, female, severe nerve impairment, large SAH, indoor hemorrhage accompanied by brain haemorrhage, acute hydrocephalus requiring outdoor cerebrofluidation, and symptomatic vascular spasms and meningitis.
in addition to the above clinical parameters, the increase of ferritin and tendon-C in cerebrospinal fluid is also related to the occurrence of shunt-dependent hydrocephalus.
, Kuo-Chuan Wang of the Department of Neurology and Internal Surgery at Taiwan University Hospital in Taipei, China, selected SAH patients with Fisher grade 3-4 grades to collect cochlear subcavity and cerebrospinal fluid in the brain room for seven days after outdoor drainage surgery, to study their biochemical components, including protein, glucose, ferrite and lactate levels, and to analyze the relationship between the cessallevel levels of the cerebrometinos in the permeitus and the sub-cobweb sciatica of the patients, published in The 2015

the study method had a higher incidence of complications of continuous brain outdoor drainage, while complications of continuous lumbar pool drainage were less.
the study assumes that the build-up of blood in the subcavity of the cobweb membrane may block the newly generated cerebrospinal fluid from the opening of the quadricular chamber into the subcavity of the cobweb, and that the ventricle is relatively independent of the metabolic and inflammatory response of the subcavity of the cobweb. As a result,
, the cerebrospinal fluid in the subcavity of the cobweb may have a greater effect on the microenvironment of the subcavity of the cobweb membrane than the cerebrospinal fluid in the brain chamber.
at the same time, the anaerobic metabolism of central nervous system cells can lead to elevated levels of lactic acid in cerebrospinal fluid.
brain trauma or SAH, increased red blood cells in the subcavity and brain chambers can also lead to elevated levels of lactic acid.
basic and clinical studies have confirmed that elevated levels of lactate in cerebrospinal fluid are also important biological markers for a variety of neurology and neurosurgery diseases.
, studies after SAH showed that elevated levels of cerebrospinal acid were associated with vascular spasms, but the relationship between lactate levels and shunt-dependent hydrocephalus has yet to be studied.

the results of the study
included 28 patients with an average age of 55.4 years and a male population of 46.6 per cent, of which 18 (64.3 per cent) were shunt-dependent hydrocephalus.
levels of protein, ferrite, hemoglobin, and lactate in the subcavity cerebrospinal fluid were relatively higher than that of cerebral heliospinal fluid, while glucose levels decreased (P 0.0001).
multivariate analysis confirms that the lactate level (P-0.036) and the brain chamber hemorrhage (P-0.05) are the independent correlation factors for the occurrence of hydrocephalus in the shunt tube.
in addition, the lactate level of the subcavity of the cobweb membrane, 5.5?m, is an effective predictor of the occurrence of hydrocephalus in the shunt tube (OR,32; 95% CI, 3.8-270.8; P-0.0015).

Conclusions The results confirm that for Fisher graded SAH patients, the lactate levels of cerebrospinal fluid in the subcavity of the cobweb membrane are more significant for predicting the occurrence of hydrocephalus than lactate levels in the brain room.
at the same time, the hemoglobin metabolism level sorgjes level sorgje, low sugar and lactate level are high, suggesting that the subcavity of the cobweb after SAH has the possibility of being partitioned. In addition,
, whether the continuous drainage of the lumbar pool can reduce the incidence of hydrocephalus in SAH patients needs further study.
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