Spontaneous Subarachnoid Haemorrhage in Neurological Setting in Burkina Faso: Clinical Profile, Causes, and Mortality Risk Factors

Abstract

To determine the prevalence, clinical profile, causes, and mortality risk factors of spontaneous arachnoid haemorrhage at Yalgado Ouedraogo University teaching Hospital, we conducted a 5-year retrospective study of 1803 stroke patients admitted to Neurology Department during the period from January 2012 to December 2016. During the study period, spontaneous subarachnoid haemorrhage accounted for 3.2 % of all stroke. The mean age of patients was 60 years (range 20-93 years). There was a female predominance in 55.9%. The common vascular risk factors were hypertension (79.7%) and chronic alcohol consumption (16.9%). The main symptoms were headache (76.2%), motor weakness (74.5%), and consciousness disorders (62.7%). Neurological examination revealed limb weakness in 76.2% and meningeal irritation in 47.4%. The best admission Glasgow Coma Scale score of 15 was found only in 37.3 % of patients. About 50.8% of patients were admitted to Hunt and Hess moderate grade (III) resulting in a mortality of 24.80%. The main cause of spontaneous subarachnoid haemorrhage was hypertension (77.9%). Cause could not be determined in 8.5 % of cases. The mortality rate was 37.3%. There was high mortality in patients with intraventricular haemorrhage and in patients with disturbances of consciousness. In conclusion, our study showed a poor frequency of spontaneous subarachnoid haemorrhage with high mortality. Hypertension was the most common cause of spontaneous subarachnoid haemorrhage.

Clinical Outcomes of Primary Subarachnoid Hemorrhage: An Exploratory Cohort Study from Sudan

“…This mortality rate is almost similar to what has been found in a nationwide observational study in Europe and Asia, Monica stroke study, which reported a 30-day mortality of 42%. 82 Also, it approximates the mortality rate of SAH in Burkina Faso (37.3%), 74 and Nigeria (44.4%), 38 and the mortality rate reported by a nationwide Danish study (38%). 83 However, this mortality rate was higher than reported in Kenya (26.6–30.4%), 37,84 Saudi Arabia (15%), 85 Morocco (18%), 86 Kashmir (20.38%), 87 Martinique (24%), 88 and developed countries.…”

“…This finding is concordant with the literature that reported the sudden headache as a cardinal symptom of SAH. 11,70-74 The SAH-associated headache is often diffuse and described by the patients as the worsening and most severe headache they have ever experienced in their life. A previous study of 364 patients with aneurysmal SAH reported the thunderclap headache as a primary warning symptom of SAH and described it as a severe, unusual, and sudden headache.…”

Post-discharge Nursing Care Needs and Problems of the Patients with Spontaneous Subarachnoid Hemorrhage who Have Undergone Therapeutic Intervention

“…The cause of sSAH can be rupture of brain aneurysm, arteriovenous malformation, hypertension, or an unknown origin. The patients may present in an emergency with symptoms like vomiting, loss of consciousness, seizures, severe headache, 1 neck stiffness, 2 . An aneurysm can be identified through angiography/CT/ MRI.…”

Continental Survey of Access to Diagnostic Tools and Endovascular Management of Aneurysmal Subarachnoid Hemorrhage in Africa

“…Indeed some African centers report needing to transfer patients to departments that can provide treatment for aSAH and this is particularly true for endovascular treatment ( 3 , 11 ). This can sometimes result in patients being transferred to other countries or even another continent for appropriate treatment; albeit the literature does not mention the mode of transportation ( 12 ). Due to these factors and the delay in presentation, aSAH patients experience limited access to and significant delays in receiving endovascular treatment but also surgical clipping, and this is particularly true for public hospitals compared to private hospitals ( 4 ).…”