Objective: To explore the network characteristics and influencing factors of core symptom clusters in middle-aged and young patients after intracerebral hemorrhage surgery, providing evidence-based reference for establishing a refined symptom management system in clinical practice. Methods: A cross-sectional survey was conducted on 185 middle-aged and young patients after intracerebral hemorrhage surgery using a general information questionnaire and the Intracerebral Hemorrhage Nursing Outcome Assessment Scale. Core symptom clusters were extracted through exploratory factor analysis. A synchronous symptom network was constructed using R software, and centrality metrics were analyzed. Multivariate linear regression was employed to examine influencing factors. Results: The top five symptom prevalence rates among middle-aged and young patients post-surgery were limb weakness (78.4%), speech impairment (72.5%), anxiety (69.2%), restricted daily activities (65.4%), and sleep disturbance (61.6%). Five core symptom clusters were identified: motor symptoms, speech impairment, psychological symptoms, reduced functional capacity, and sleep disturbance, collectively accounting for 67.3% of variance. The motor symptoms cluster contributed the highest variance across all dimensions. Symptom network analysis revealed that limb weakness exhibited the highest closeness and betweenness centrality, positioning it as the core bridging symptom. Anxiety demonstrated the highest strength centrality, making it the most prominent emotional symptom. Factor analysis indicated that the severity of core symptom clusters was independently influenced by the degree of neurological deficit, number of postoperative complications, level of social support, and anxiety-depression status (P<0.05). Conclusion: Middle-aged and young patients after intracerebral hemorrhage experience overlapping multidimensional core symptom clusters. The somatic motor symptom cluster is the most stable core cluster, with limb weakness serving as the core bridging symptom in the symptom network. Clinicians should develop stratified, precise symptom management strategies based on symptom cluster characteristics, network structure, and influencing factors to improve functional outcomes and quality of life.

Young and Middle-aged Adults, Postoperative Intracerebral Hemorrhage, Symptom Clusters, Network Analysis