Study on the risk factors for hemorrhagic transformation of cerebellar infarction after posterior fossa decompression surgery

Abstract

Objective: To investigate the related risk factors for hemorrhagic transformation (HT) of cerebellar infarction after posterior fossa decompression surgery. Methods: A total of 91 patients with cerebellar infarction were treated by posterior fossa decompression surgery in Department of Neurosurgery of Jinhua Municipal Central Hospital from Jan 2010 to Jan 2018, were selected as study subjects. The HT group included 17 cases, while the Non-HT group included 74 cases. The clinical data of the two groups were analyzed retrospectively, the univariate and non-conditional lgistic regression analysis were performed to detect the relevant risk factors for hemorrhagic transformation of cerebellar infarction after posterior fossa decompression surgery. Results: By univariate analysis, the differences of these seven risk factors, the large area cerebellar infarction (the diameter of area was larger than 5 cm), pre-op thrombolysis, pre-op mild HT, oral anticoagulants, atrial fibrillation, hyperglycemia and fluctuation of BP in post-op, between two groups were statistically significant (P<0.05). By multivariate logistic analysis, the large area cerebellar infarction (P<0.05), pre-op thrombolysis(P<0.01), pre-op mild HT (P<0.01), oral anticoagulants (P<0.01) were the independent risk factors for post-op HT. Conclusions: The large area cerebellar infarction (the diameter of area was more than 5 cm), pre-op thrombolysis, pre-op mild HT, oral anticoagulants, atrial fibrillation, hyperglycemia and fluctuation of BP in post-op are important risk factors for post-op HT. The large area cerebellar infarction, pre-op thrombolysis, pre-op mild HT, oral anticoagulants are the independent risk factors for post-op HT. A proper pre-op evaluation of these risk factors and an individualized treatment for post-op HT would help a lot with balancing operational risk and improving prognosis.