Trends in Case-Fatality Rates in Hospitalized Nontraumatic Subarachnoid Hemorrhage

Biotti, Damien; Jacquin, Agnès; Boutarbouch, Mahjouba; Bousquet, Olivier; Durier, Jérôme; Salem, Douraı̈ed Ben; Ricolfi, F.; Beaurain, Jacques; Osseby, Guy‐Victor; Moreau, Thibault; Giroud, Maurice; Béjot, Yannick

doi:10.1227/01.neu.0000369512.58898.99

Cited by 25 publications

(17 citation statements)

References 18 publications

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“…SAH is associated with 20% to 45% mortality [134][135][136] and 10% severe disability, 136 although more comprehensive assessments demonstrate much higher rates of cognitive, social, and health disability. 137,138 SAH is not a diagnosis based on symptoms alone but rather is defined by the presence of bleeding in the subarachnoid space, confirmed by either imaging or by sampling of the CSF that occupies and circulates within the subarachnoid space.…”

Section: Subarachnoid Hemorrhagementioning

confidence: 99%

An Updated Definition of Stroke for the 21st Century

Sacco¹,

Kasner²,

Broderick³

et al. 2013

Stroke

2,454

1,029

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Despite the global impact and advances in understanding the pathophysiology of cerebrovascular diseases, the term “stroke” is not consistently defined in clinical practice, in clinical research, or in assessments of the public health. The classic definition is mainly clinical and does not account for advances in science and technology. The Stroke Council of the American Heart Association/American Stroke Association convened a writing group to develop an expert consensus document for an updated definition of stroke for the 21st century. Central nervous system infarction is defined as brain, spinal cord, or retinal cell death attributable to ischemia, based on neuropathological, neuroimaging, and/or clinical evidence of permanent injury. Central nervous system infarction occurs over a clinical spectrum: Ischemic stroke specifically refers to central nervous system infarction accompanied by overt symptoms, while silent infarction by definition causes no known symptoms. Stroke also broadly includes intracerebral hemorrhage and subarachnoid hemorrhage. The updated definition of stroke incorporates clinical and tissue criteria and can be incorporated into practice, research, and assessments of the public health.

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Section: Subarachnoid Hemorrhagementioning

confidence: 99%

An Updated Definition of Stroke for the 21st Century

Sacco¹,

Kasner²,

Broderick³

et al. 2013

Stroke

2,454

1,029

View full text Add to dashboard Cite

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“…2 . Approximately 12% of patients die before receiving medical attention 3 ; one month case-fatality rates for hospitalized patients range from 15-30% 4, 5 and more than one third of those who survive have major neurologic deficits 4 . Furthermore, persistent cognitive deficits are present in many survivors.…”

Section: Introductionmentioning

confidence: 99%

Aspirin as a Promising Agent for Decreasing Incidence of Cerebral Aneurysm Rupture

Hasan

Mahaney²,

Brown³

et al. 2011

Stroke

219

169

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Background and Purpose Chronic inflammation is postulated as an important phenomenon in intracranial aneurysm (IA) wall pathophysiology. This study was conducted to determine if aspirin use impacts the occurrence of IA rupture. Methods Subjects enrolled in the International Study of Unruptured Intracranial Aneurysms (ISUIA) were selected from the prospective untreated cohort (n=1691) in a nested case-control study. Cases were subjects who subsequently suffered a proven aneurysmal SAH during a 5-year follow-up period. Four controls were matched to each case by site and size of aneurysm (58 cases, 213 controls). Frequency of aspirin use was determined at baseline interview. Aspirin frequency groups were analyzed for risk of aneurysmal hemorrhage. Bivariable and multivariable analyses were performed using conditional logistic regression. Results A trend of a protective effect for risk of UIA rupture was observed. Patients who used aspirin 3x weekly - daily had an odds ratio (OR) for hemorrhage of 0.40 [95% CI=0.18-0.87, reference group = no use of aspirin], patients in the “< once a month” group had an OR of 0.80 (95% CI=0.31-2.05) and patients in the “> once a month – 2x/week” group had an OR of 0.87 (95% CI=0.27-2.81) (p= 0.025). In multivariable risk factor analyses, patients who used aspirin three times weekly to daily had a significantly lower odds of hemorrhage (Adjusted OR=0.27, 95% CI 0.11-0.67, p=0.03) compared to those who never take aspirin. Conclusions Frequent aspirin use may confer a protective effect for risk of IA rupture. Future investigation in animal models and clinical studies is needed.

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“…2,12,13,15,16,29,30 It has been shown that the rebleeding rate is highest on the day of the initial SAH, especially within 6 hours after onset, and it decreases steeply after 6 hours following SAH. 10,[12][13][14]17,19 Early recognition of the signs and symptoms of SAH and prompt referral to facilities where proper diagnostic and therapeutic techniques are available are essential for improvement of overall outcome.…”

mentioning

confidence: 99%