Early brain injury (EBI) is considered an important cause of morbidity and mortality after aneurysmal subarachnoid hemorrhage (aSAH). As a factor in EBI, microcirculatory dysfunction has become a focus of interest, but whether microcirculatory dysfunction is more important than angiographic vasospasm (aVS) remains unclear. Using data from 128 cases, we measured the time to peak (TTP) in several regions of interest on digital subtraction angiography. The intracerebral circulation time (iCCT) was obtained between the TTP in the ultra-early phase (the baseline iCCT) and in the subacute phase and/or at delayed cerebral ischemia (DCI) onset (the follow-up iCCT). In addition, the difference in the iCCT was calculated by subtracting the baseline iCCT from the follow-up iCCT. Univariate analysis showed that DCI was significantly increased in those patients with a prolonged baseline iCCT, prolonged follow-up iCCT, increased differences in the iCCT, and with severe aVS. Poor outcome was significantly increased in patients with prolonged follow-up iCCT and increased differences in the iCCT. Multivariate analysis revealed that increased differences in the iCCT were a significant risk factor that increased DCI and poor outcome. The results suggest that the increasing microcirculatory dysfunction over time, not aVS, causes DCI and poor outcome after aneurysmal aSAH.

早期脑损伤 (EBI) 被认为是动脉瘤性蛛网膜下腔出血 (aSAH) 后发病率和死亡率的重要原因。作为 EBI 的一个因素，微循环功能障碍已成为人们关注的焦点，但微循环功能障碍是否比血管造影血管痉挛 (aVS) 更重要仍不清楚。使用来自 128 个病例的数据，我们测量了数字减影血管造影中几个感兴趣区域的达峰时间 (TTP)。在超早期（基线 iCCT）和亚急性期和/或延迟性脑缺血（DCI）发作（后续 iCCT）的 TTP 之间获得脑内循环时间（iCCT）。此外，通过从后续 iCCT 中减去基线 iCCT 来计算 iCCT 的差异。单变量分析显示，基线 iCCT 延长、iCCT 随访时间延长、iCCT 差异增加和严重 aVS 患者的 DCI 显着增加。长期随访 iCCT 和 iCCT 差异增加的患者的不良结果显着增加。多变量分析显示，iCCT 差异增加是增加 DCI 和不良结果的重要危险因素。结果表明，随着时间的推移，微循环功能障碍的增加，而不是 aVS，导致动脉瘤性 aSAH 后的 DCI 和不良结果。多变量分析显示，iCCT 差异增加是增加 DCI 和不良结果的重要危险因素。结果表明，随着时间的推移，微循环功能障碍的增加，而不是 aVS，导致动脉瘤性 aSAH 后的 DCI 和不良结果。多变量分析显示，iCCT 差异增加是增加 DCI 和不良结果的重要危险因素。结果表明，随着时间的推移，微循环功能障碍的增加，而不是 aVS，导致动脉瘤性 aSAH 后的 DCI 和不良结果。