Supplementary Material for: Clinical Significance of Cytotoxic Lesions of the Corpus Callosum in Subarachnoid Hemorrhage Patients: A Retrospective Analysis

Introduction: Cytotoxic lesions of the corpus callosum are secondary lesions induced by significant increases in cytokine levels in the brain and are associated with subarachnoid hemorrhage (SAH). However, their clinical significance in SAH patients remains unclear. Methods: We retrospectively analyzed SAH patients who were treated in our hospital and evaluated between-group differences in the backgrounds, clinical findings, and outcomes between SAH patients who developed cytotoxic lesions of the corpus callosum and those who did not. We further compared patients who achieved good outcomes with those who had poor outcomes. Multivariate logistic regression analysis was used to identify risk factors for poor clinical outcomes. Results: We analyzed 159 SAH patients; 17 patients (10.7%) had cytotoxic lesions of the corpus callosum. Patients with cytotoxic lesions of the corpus callosum were more likely to be in a severe condition (World Federation of Neurosurgical Societies grading IV-V: odds ratio [OR], 4.53; 95% confidence interval [95% CI]: 1.60–12.84; p = 0.0042) and have an intraventricular (OR, 5.98; 95% CI: 1.32–27.13; p = 0.0054) or an intraparenchymal hematoma (OR, 3.62; 95% CI: 1.25–10.45; p = 0.023). Patients with cytotoxic lesions of the corpus callosum had a greater propensity of a poor outcome 3 months after onset (modified Rankin Scale score 0–2: OR, 0.22; 95% CI: 0.07–0.66; p = 0.0043). Multivariate analysis confirmed that cytotoxic lesions of the corpus callosum increased the risk of a poor outcome (OR, 4.39; 95% CI: 1.06–18.1; p = 0.037). Discussion/Conclusions: The development of cytotoxic lesions of the corpus callosum may be related to the extent of hematomas in SAH patients. Although they are usually reversible lesions, the development of cytotoxic lesions of the corpus callosum may be a predictor of poor outcomes in SAH patients.引言：胼胝体细胞毒性病变（Cytotoxic lesions of the corpus callosum）是由脑内细胞因子水平显著升高诱导的继发性病变，与蛛网膜下腔出血（subarachnoid hemorrhage, SAH）密切相关。然而，此类病变在蛛网膜下腔出血患者中的临床意义仍未明确。 方法：本研究回顾性分析了本院收治的蛛网膜下腔出血患者，对比合并胼胝体细胞毒性病变的患者与未合并该病变的患者在基线特征、临床表现及预后结局上的组间差异。此外，本研究进一步比较了预后良好与预后不良的患者，并采用多因素logistic回归分析明确临床不良预后的危险因素。 结果：本研究共纳入159例蛛网膜下腔出血患者，其中17例（10.7%）合并胼胝体细胞毒性病变。合并该病变的患者病情更危重（世界神经外科联合会（World Federation of Neurosurgical Societies, WFNS）分级IV~V级：比值比（odds ratio, OR）=4.53，95%置信区间（95% confidence interval, 95%CI）=1.60~12.84，P=0.0042），且更易并发脑室内血肿（OR=5.98，95%CI=1.32~27.13，P=0.0054）或脑实质内血肿（OR=3.62，95%CI=1.25~10.45，P=0.023）。发病3个月时，合并胼胝体细胞毒性病变的患者不良预后风险更高（改良Rankin量表（modified Rankin Scale, mRS）评分0~2分：OR=0.22，95%CI=0.07~0.66，P=0.0043）。多因素分析证实，胼胝体细胞毒性病变可升高不良预后风险（OR=4.39，95%CI=1.06~18.1，P=0.037）。 讨论与结论：蛛网膜下腔出血患者的胼胝体细胞毒性病变发生可能与血肿累及范围相关。尽管此类病变通常为可逆性病变，但其发生可作为蛛网膜下腔出血患者不良预后的潜在预测指标。