ORIGINAL ARTICLE   

Journal of Neurosurgical Sciences 2023 May 09

DOI: 10.23736/S0390-5616.22.05664-8

Copyright © 2022 EDIZIONI MINERVA MEDICA

language: English

Application of electromagnetic disturbance technology in predicting ventriculoperitoneal shunt dependency after aneurysm-associated subarachnoid hemorrhage

Lanjuan XU ¹, Fen MEI ², Haorun HUANG ², Meiqi LIU ³, Jiawen TAN ⁴, Haoxin LIANG ⁵, Bo YANG ¹, Yun BAO ² ✉

¹ Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; ² Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, China; ³ The First Clinical College, Southern Medical University, Guangzhou, China; ⁴ Institute for Hospital Management, Tsinghua University, Beijing, China; ⁵ College of Nursing, Southern Medical University, Guangzhou, China

BACKGROUND: The aim of this study was to evaluate the predictive power of electromagnetic disturbance technology in patients with hydrocephalus after subarachnoid hemorrhage.
METHODS: This prospective, observational cohort study was conducted at The First Affiliated Hospital of Zhengzhou University and Nanfang Hospital. A total of 155 patients with subarachnoid hemorrhage (SAH) were enrolled in this study. Disturbance coefficients were recorded using a continuous sinusoidal signal in real time after SAH. The patients were divided into two groups: hydrocephalus group (patients who underwent shunt insertion within a month after SAH) and non-hydrocephalus group (patients without need for a ventriculoperitoneal shunt). We used SPSS to draw a ROC Curve to assess the ability of disturbance coefficients to predict the probability of hydrocephalus.
RESULTS: Hydrocephalus occurred in 37 patients after SAH. The average disturbance coefficient of patients with hydrocephalus decreased by 25.14±9.78, and the disturbance coefficient of patients with no hydrocephalus decreased by 6.58±10.10 (one aspect of the present invention is a system of non-invasively monitoring hydrocephalus, cerebral edema, and intracranial bleeding comprising of a source emitting electromagnetic waves to brain tissue, a detector detecting said wave that propagates through said tissue, a signal conditioning unit amplifying and filtering said wave, a quadrature detector estimating magnitude and phases of said wave, and a parameter estimator calculating the complex wave number, relative attenuation coefficient (RAC), relative phase shift (RPS), wave speed change (WSC), and travel-time difference (TTD) of said brain, and assessing status of hydrocephalus and cerebral edema). The difference was statistically significant (t=9.825, P<0.001). The decrease in disturbance coefficient can be used to predict the occurrence of hydrocephalus, and if the disturbance coefficient decreases by more than 15.5 (sensitivity, 92.37%; specificity, 86.49%), it can be used to indicate the occurrence of hydrocephalus.
CONCLUSIONS: The disturbance coefficient can predict the occurrence of hydrocephalus. The greater decline of the disturbance coefficient, the greater probability of occurrence of intracranial hydrocephalus. Hydrocephalus can be early detected. However, the CT scan is necessary to confirm the occurrence of hydrocephalus. Early diagnosis and early treatment may improve the prognosis of patients with hydrocephalus after subarachnoid hemorrhage.

KEY WORDS: Subarachnoid hemorrhage; Aneurysm; Hydrocephalus