Demographics of Aneurysmal Subarachnoid Hemorrhage
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The characteristics of cerebral aneurysms in Japan differ from other countries in the higher incidence of unruptured cerebral aneurysm detected by brain check-up screening, higher rupture rate of unruptured cerebral aneurysm, higher incidence of subarachnoid hemorrhage, and superior outcome after subarachnoid hemorrhage based on meta-analysis. Head shape, genetic features, environmental factors, demographics, and medical system in Japan are also different from other countries. Unruptured cerebral aneurysms are 2.8 times more likely to rupture in Japanese than western aneurysms, resulting in the highest incidence of subarachnoid hemorrhage in the world. The exact and specific mechanisms of de novo, growth, and rupture of cerebral aneurysms have not been elucidated. Investigations will contribute to the understanding of cerebral aneurysms and subarachnoid hemorrhage worldwide. Some features of cerebral aneurysm in Japan are discussed for possible research guidance in the elucidation of the predominance of subarachnoid hemorrhage in Japan.
Demographics
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The overall management results after aneurysmal rupture were studied in 158 patients admitted to the hospital on day 0--3 and 175 patients admitted on day 4--7 following subarachnoid hemorrhage. In this series surgery was planned no sooner than 12 days following the ictus. Despite effective medical and surgical therapy overall results were disappointing: 3 months following the initial hemorrhage only 43% of patients in the 0--3 day group and 53% of patients in the 4--7 day group were capable of independent functional living. Patients admitted on days 4--7 also had a lower mortality rate, re-bled less frequently, and had lower postoperative mortality and morbidity than those admitted on days 0--3. For reasons not well defined, time of admission following aneurysmal SAH has an important influence on outcome. Accordingly, in evaluating outcome for patients with ruptured aneurysms treated with different therapeutic modalities, time of admission must be carefully controlled.
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Cerebral Vasospasm
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Tenenbein, PK MD, FRCPC; Godhke, B MD; Britz, GW MD, MPH; Sekhar, LN MD; Lam, AM MD, FRCPC Author Information
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Pandemic
Demographics
Stroke
Subarachnoid haemorrhage
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Background: Subarachnoid hemorrhage has a high mortality and morbidity rates, and the cerebral aneurysm is the most common cause. The location of the ruptured cerebral aneurysm is diagnosed by cerebral angiogram and by computed tomography (CT) pattern of the subarachnoid hemorrhage. Objective: To find the incidence of CT pattern of each cerebral aneurysm and the correlation between CT pattern of subarachnoid hemorrhage and each location of cerebral aneurysm. Materials and Methods: The 126 patients with ruptured cerebral aneurysm were included in the present study. The information of the patients and CT were recorded and analyzed. Results: There were 49 male and 77 female patients. The highest location of cerebral aneurysm is anterior communicating aneurysm (59 patients, 47.6%). There were correlations between A region and anterior cerebral and anterior communicating aneurysm, and left D legion and the other location aneurysm. There were correlations between intracerebral hemorrhage and anterior communication, posterior communication cerebral, and anterior cerebral and middle cerebral artery aneurysm. Conclusion: The common location of cerebral aneurysm is anterior communicating artery aneurysm. There are correlations between the most thickness region of A and D region with anterior communicating aneurysm and the posterior circulation aneurysm, and the correlation between intracerebral hemorrhage and anterior communicating aneurysm, posterior communicating aneurysm, and middle cerebral artery aneurysm. Keywords: Subarachnoid hemorrhage, Cerebral aneurysm, Intracerebral hemorrhage, Thickness
Anterior communicating artery
Anterior cerebral artery
Posterior communicating artery
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