Subarachnoid hemorrhage in middle-Finland: incidence, early prognosis and indications for neurosurgical treatment.

Abstract

SUMMARY The incidence of subarachnoid hemorrhage (SAH) in Middle-Finland during 1976-78 was 19.4/100,000/year. The incidence increased consistently with age. The early prognosis was similar to that in earlier studies, with 25% dying on the first day, and 49% during the first 3 months after the initial bleeding. The fatality rate decreased sharply after the bleeding: of all deaths during the first 3 months, the weekly fatality rate was 65% during the 1st week, 12% during the 2nd, and 4% during the 3rd. Thereafter the weekly fatalities up to 3 months averaged 1.6%.Only 20% of the patients of the entire series were assessed as being eligible for neurosurgical treatment. Intercurrent fatal rebleeds further reduced this number. The chances of increasing the number of SAH patients suitable for neurosurgery are discussed. The timing of surgery should be earlier than in the present study (median 15 days after the bleeding) in order to avoid frequently fatal recurrences. Vertebral angiograms should be obtained from patients with no aneurysms found by bilateral carotid angiography. The upper age limit of 60 years should be abolished. By these means the proportion of SAH patients potentially eligible for neurosurgery could be increased to about 40%.Stroke, Vol 12, No 3, 1981

Incidence of Aneurysmal Subarachnoid Hemorrhage in Shimokita, Japan, From 1989 to 1998

“…However, by pooling our data with that from other studies with a high number of cases and a large population denominator, we were able to show that rates are higher in women ( Figure 3). 5,8,9,12,21 In men, the annual incidence of SAH ranged from 34.5 and 51.3 per 100 000 population over the age of 40 years. Conversely, in women, the annual incidence increased with age and reached peaks between 58.0 and 66.9 per 100 000 population after the age of 60 years.…”

Incidence of subarachnoid hemorrhage is decreasing together with decreasing smoking rates

“…[23][24][25][26] Fogelholm 27 suggested that the exclusion of nearly 40% of the population (,25-year-old and .74-year-old people) resulted in incomparable rates with earlier studies that included all age groups. This proved to be so, as after an adjustment to the Finnish population in 1986, the incidence rates of 5 previous studies [21][22][23][24]26 varied from 14.4 to 19.6 per 100,000 person-years. 27 Inconsistent incidence rates occur also in those previous studies, which report changes in the Finnish incidence of SAH over time.…”

The Incidence of Aneurysmal Subarachnoid Hemorrhage in Youngdong District, Korea

“…Since the era of the computed tomography, the lower incidences were reported in England, France, and USA ranging from 2 to 10 annual incidences per 100,000 populations 3,6,11) . However, higher results exceeding 20 annual incidence per 100,000 populations were reported in some published studies from Japan and Finland 9,10,12,14,18,20,25) . The estimated incidence can be influenced by the age and size of population studied, difference on diagnostic accuracy, criteria adopted to define the aneurysmal SAH, type of study, and methodology for collecting data.…”

“…To our knowledge, however, there had been no reports on the geographical incidence of aneurysmal SAH in Korea, so we compared our results with the results from other parts of the world including Japan (Table 7). According to the previous studies, the annual incidences of spontaneous SAH varied from 2 to 23/100,000/yr in all age group 3,[5][6][7][9][10][11][12]14,18,20,25) . The incidences of SAH in Finland and Japan are among the highest in the world, otherwise lower incidences of SAH have been reported from England, France, and USA.…”

“…The incidence of aneurysmal SAH has ranged widely among reports from different regions of the world and at different points in time 3,[5][6][7][9][10][11][12]14,18,20,25) . Since the era of the computed tomography, the lower incidences were reported in England, France, and USA ranging from 2 to 10 annual incidences per 100,000 populations 3,6,11) .…”