To investigate the relevant risk factors of lateral ventricular frontal angle puncture injury during intracranial aneurysm operation.

The clinical data and CT data of 97 patients who underwent lateral ventricular frontal angle puncture during craniotomy and clipping of aneurysms in Neurosurgery Department of Shanxi Dayi Hospital Affiliated to Shanxi Medical University from January 2017 to October 2018 were collected. According to the presence or absence of injury, the patients were divided into puncture injury group (26 cases) and puncture no injury group (71 cases). The clinical data of the two groups were compared, and the risk factors of injury were determined by univariate and multivariate Logistic regression analysis.

Univariate analysis showed that GCS score, Fisher grade, preoperative smaller ventricle, the distance between puncture point and lateral fissure, distance between puncture point and orbital apex and midline deviation were compared between the two groups, the difference was statistically significant (P<0.05); Multivariate Logistic regression analysis found that the smaller ventricle (OR=10.232, 95%CI: 1.475-70.961), the higher Fisher grade (OR=11.527, 95%CI: 2.235-59.462) and the closer distance between puncture point and lateral fissure (OR=2.384, 95%CI: 1.106-5.137) were the risk factors of lateral ventricular puncture injury.

Smaller preoperative ventricles, higher Fisher grade and closer distance between puncture point and lateral fissure were the risk factors of puncture injury. For those with small ventricle, higher Fisher grade and brain tissue structure displacement, assisted-guided puncture is recommended.