BACKGROUND: Early rebleeding after coiling of a ruptured intracranial aneurysm (IA) may cause disability or death. The incidence and predictors of early rebleeding have previously been sparsely investigated. PURPOSE: To assess the incidence and risk factors of early rebleeding after coiling of a ruptured IA and to analyze the outcome of the patients suffering early rehemorrhage. MATERIAL AND METHODS: The data of 194 consecutive acutely (within 3 days) coiled patients with saccular ruptured IAs were analyzed. Age, gender, hypertension, aneurysm multiplicity, Hunt et Hess (HH) grade, intracerebral hematoma (ICH), intraventricular hematoma (IVH), external ventricular drainage (EVD), aneurysm location and size, and the grade of the initial aneurysm occlusion were tested to find the risk factors for early rebleeding. The outcome of the patients suffering rehemorrhage was verified. RESULTS: Early rebleeding after coiling occurred in 7 patients out of 194 (3.6%). The presence of an ICH at admission and HH grade 3-5 before coiling were significant risk factors for rebleeding. An early rehemorrhage appeared as an enlargement of the initial ICH in all of these patients. Six of seven patients had good outcome (Glasgow Outcome Scale, GOS, 3-5). Logistic regression analysis did not find any other statistically significant risk factors. CONCLUSION: The incidence of early rebleeding after acutely coiled ruptured IA was 3.6%. Risk factors for post-procedural rehemorrhage were the presence of ICH on the initial CT and HH grade 3-5 before coiling. Early rebleeding appeared exclusively as an enlargement of the initial ICH and not an increased amount of blood in the subarachnoid space.
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机译：背景：盘绕破裂的颅内动脉瘤（IA）后早期再出血可能导致残疾或死亡。先前已经很少研究早期再出血的发生率和预测因素。目的：评估IA破裂后早期出血的发生率和危险因素，并分析早期再出血患者的结局。材料与方法：分析了194例连续（3天内）囊性破裂IAs的盘绕患者的数据。年龄，性别，高血压，动脉瘤多样性，Hunt et Hess（HH）级，脑内血肿（ICH），脑室内血肿（IVH），脑室引流（EVD），动脉瘤的位置和大小以及初始动脉瘤闭塞的程度测试以发现早期出血的危险因素。再次出血患者的结局得到了证实。结果：194名患者中有7名（3.6％）出现了卷曲后的早期再出血。入院时存在ICH，卷取前HH为3-5，是再出血的重要危险因素。在所有这些患者中，早期出血似乎是初始脑出血的扩大。 7例患者中有6例具有良好的预后（格拉斯哥成果量表，GOS，3-5）。 Logistic回归分析未发现任何其他统计学上显着的风险因素。结论：急性盘绕IA破裂后早期再出血的发生率为3.6％。术后再出血的危险因素是初次CT时存在ICH，并且在盘绕之前HH为3-5级。早期再出血仅表现为初始ICH的增大，而蛛网膜下腔的血液却没有增加。
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