Analysis of Subarachnoid Hemorrhage According to the Japanese Standard Stroke Registry Study-Incidence, Outcome, and Comparison With the International Subarachnoid Aneurysm Trial-

Abstract

The data for subarachnoid hemorrhage (SAH) from the Japanese Standard Stroke Registry Study (JSSRS) were analyzed to evaluate the incidence of SAH according to age, neurological grading and outcome, and outcome of surgical clipping, for comparison with the International Subarachnoid Aneurysm Trial (ISAT). From the ISSRS data, the peak incidence of SAH was the sixth decade in males and the eighth decade in females. The overall mortality was 22%, and good outcome, better than 2 on the modified Rankin Scale (mRS), at discharge was achieved in 58% of cases. Radical treatment was performed in 62.6% of all SAH cases, 58.7% with surgical clipping and 3.2% with endovascular coiling. Poor outcome, worse than 3 on the mRS, occurred in 26.6% of patients under 60 years, 47.3% between 60-69 years, 54.2% between 70-79 years, and 72.9% 80 years or over. From the ISAT data, 88% of patients were in grades 1-2 of the World Federation of Neurological Surgeons (WFNS) grading system in both surgical clipping and endovascular coiling groups, 94% in grades 1-3, and 98% in grades 1-4. Poor outcome, worse than 3 on the mRS, at 2 months occurred in 25.4% and 36.4% of patients with endovascular coiling and surgical clipping, respectively. Limiting the patients in the JSSRS to WFNS grades 1-2 showed poor outcome, worse than 3 on the mRS, occurred in 12.8%, and in grades 1-3 and 1-4 occurred in only 16.3% and 23.0%, respectively.

Interleukin-1 Receptor Antagonist Penetrates Human Brain at Experimentally Therapeutic Concentrations

“…The patients in this study were a selected subpopulation of all subarachnoid patients with clinical indications for insertion of EVDs, who generally reflected a more severely ill subgroup. Patients (50%) were of good grade at the end of the study as compared with 58% in a recent study (Ikawa et al, 2004), and the mortality of 12.5% in our small series was well within mortality rates reported elsewhere (Lozier et al, 2002).…”

Sex-Related Differences in Patients Treated Surgically for Aneurysmal Subarachnoid Hemorrhage

“…Aneurysmal SAH occurs more frequently in women than in men, 4,8) but the reasons are still unknown. Lifestyle differences such as smoking, history of hypertension, and alcohol abuse might help explain such sex disparity.…”

“…[1][2][3][4]13) Aneurysmal SAH is known to occur more frequently in women than in men. 4,8,10) However, the influence of sex on the clinical course of patients treated surgically for aneurysmal SAH has received less attention. The present study evaluated sex differences in patients with aneurysmal SAH using our database.…”

Acute Lung Injury Associated With Systemic Inflammatory Response Syndrome Following Subarachnoid Hemorrhage: a Survey by the Shonan Neurosurgical Association

“…7,10) The mortality of SAH has exceeded 20% in recent reports, indicating that the prognosis for patients with SAH remains poor. 4,6,7) Initial hemorrhage and vasospasm are the major causes of the poor prognosis, but systemic or postoperative complications may also be responsible in more than 10% of cases. 5,16) Systemic complications include a high frequency of respiratory dysfunction, which results in death in about 10% of patients who die after SAH.…”