Background Early brain edema and/or Hematoma after aneurysmal subarachnoid hemorrhage (a-SAH) is an important impact determinant of clinical cognition outcomes. However, due to the lack of early assessment of the impact on cognitive structural systems, Therefore, there is a need to develop early predictive and/or decision-making models, termed the a-SAH Early Brain Edema/Hematoma Compression Neural (Structural Brain) Networks Score System (SEBE-HCNNSS). Methods 202 consecutive patients with spontaneous a-SAH and initial CT/ magnetic resonance imaging (MRI) scans (24 h of ictus) and follow-up 2 months. Clinically relevant factors and a variety of traditional different scale ratings were defined using Linear regression analysis (Univariate, multivariate). The risk factors with highest values for area under the curve (AUC) were included in the multivariate analysis and least absolute shrinkage and selection operator (LASSO) analysis or Cox regression analysis. Results A total of 177 patients were enrolled in this study, 43 patients had a high SEBE-HCNNSS classification (grade 3 to 5). After a mean follow-up of 2month, 121 individuals (68.36%) with a-SAH and 3 control subjects had incident CI. The CT inter-observer reliability of the SEBE-HCNNSS scale was high, with a Kappa value of 1. ROC analysis showed that the SEBE-HCNNSS scale (OR 3.322, 95% CI 2.312-7.237, p = 0.00025) was determined to be an independent predictor of edema, CI and unfavorable prognosis. These results were replicated in validation cohort. Conclusions SEBE-HCNNSS scale is fairly easy to perform and this study indicates that is good predictor value for CI and clinical outcomes after SAH. we suggest that it is practically useful prognostic instrument for the risk evaluation after a-SAH.

The authors have declared no competing interest.

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The study protocol was approved by the Institutional Review Board (Clinical Research Ethics Committee of the First Hospital of Hebei Medical University, ID: 2023-1001), and all participants and their proxies provided written informed consent.

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