Potential triggering factors associated with aneurysmal subarachnoid hemorrhage: A large single‐center retrospective study

Abstract

Controlling blood pressure levels is critical to preventing intracranial aneurysm rupture, and a summary review of induced rupture events allows better health education for patients. We retrospectively reviewed all medical records of consecutive patients with aneurysmal subarachnoid hemorrhage (aSAH) admitted to Beijing Tiantan Hospital from 2015 to 2020. We collected patients' demographic information, aneurysm morphology, blood pressure level on admission, time to onset, and events at the time of aneurysm rupture to analyze the factors precipitating aneurysmal rupture. A total of 764 patients were enrolled for analysis, including 461 (60.3%) female patients and 303 (39.7%) male patients. The mean age of onset in this cohort was 55, and 465 (60.9%) patients had hypertension history. Autumn (245/764 [32.1%]) was the most frequent season for aneurysm rupture, and 07:00-12:59 (277/764 [36.3%]) was the most frequent time frame for aneurysm rupture. The five most prevalent events when aneurysm rupture happened were: (1) daily behaviors that may induce hypertension (181/764 [23.7%]), especially defecation or micturition (116/181 [64.1%]); (2) sporting (162/764 [21.2%]), especially high-intensity sports (108/162 [66.7%]); (3) mood and mental factors (112/764 [14.7%]), especially arguing or quarreling (61/112 [54.5%]); (4) sudden postural changes (93/764 [12.2%]), especially getting up (69/93 [74.2%]); and (5) sleeping (72/764 [9.4%]). Patients should avoid behaviors that may cause fluctuations in blood pressure, including keeping warm during seasonal alternation, keeping their urine and defecation unobstructed, avoiding high intensity physical exercise, maintaining a happy mood, avoiding sudden postural changes, and should not bathe with too cold or too hot water.

Effect of exercise-nutrition-psychology oriented nursing in patients undergoing interventional embolization for intracranial aneurysm

“…The late recovery of patients is very important, which is related to their overall recovery [22,23]. Therefore, in the process of postoperative rehabilitation, health education needs to be strengthened before discharge, so as to make patients understand the precautions to be taken after discharge, ensure regular work and [24], which are similar to our findings. Our results together suggest that effective nursing interventions can accelerate patients' recovery, guide the postoperative rehabilitation, and contribute to relieving clinical symptoms, shortening hospital stay, as well as improving prognosis.…”

“…Study has shown that postoperative patients are prone to obstructed limb blood circulation and gastrointestinal peristalsis due to prolonged bed rest, which can lead to a variety of rest time, adhere to the healthy behaviors, and comply with the medical advice to review on time to get a good rehabilitation results [24].…”

Aneurysms in the Times of the Climatic Change

“…For example, a study conducted in Beijing found that the incidence of ruptures of intracranial aneurysms was higher in seasons with higher average temperatures. The study also reported that it was higher in seasons with more significant temperature variations [9].…”

Association of aneurysmatic subarachnoid hemorrhage rate with environmental changes or emotional bursts

“…The differences in the numbers of events are statistically significant, since the number of cases for 4745 days (13 years) allows to identify differences, which can be small but still statistical significant. A recent study indicates hypertension, as well as arguing or quarrelling and seasonality (autumn) as a risk factors of aneurysm rupture [ 2 ]. Carnival is such a period of arguing and quarreling, where we see a rise of SAH.…”