• Yibing Yang, Kejun He, Linfeng Liu, Fanying Li, Guofeng Zhang, Baoshu Xie, and Feng Liang.
• Neurosurgery Unit, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
• World Neurosurg. 2023 Mar 1; 171: e186e194e186-e194.

ObjectiveThe study aimed to explore risk factors for cerebral infarction after microsurgical clipping in patients with Hunt-Hess grade 0-2 single intracranial aneurysms.MethodsA total of 137 patients with Hunt-Hess grade 0-2 single intracranial aneurysms treated with microsurgical clipping between March 2017 and December 2020 were retrospectively enrolled. Patients were divided into 2 groups on the basis of the occurrence of cerebral infarction after surgery.ResultsOf 137 enrolled patients, 14 (10.22%) showed cerebral infarction symptoms after surgery. Univariate analysis indicated that ruptured aneurysm status, aneurysm rupture during surgery, history of transient ischemic attack (TIA)/stroke, aneurysm size ≥7 mm, temporary clipping, intraoperative systolic hypotension (IOH), and occurrences of intraoperative motor-evoked potentials change were significantly related to postoperative cerebral infarction (PCI). However, using multivariate regression, only history of TIA/stroke (odds ratio = 0.124; 95% confidence interval [CI] = 0.021-0.748, P = 0.023) and IOH (odds ratio = 0.032; 95% CI = 0.005-0.210, P < 0.001) were independent predictors for PCI. Receiver operating characteristic curve analysis showed that the critical duration of temporary clipping and IOH that minimized the risk of PCI was 5.5 minutes and 7.5 minutes, respectively.ConclusionsOur study identified history of TIA/stroke and IOH as independent risk factors for cerebral infarction after microsurgical clipping.Copyright © 2022 Elsevier Inc. All rights reserved.

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