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Open Access 01-12-2024 | Aneurysm | Original Article

Trends in incidence and treatments of spontaneous subarachnoid hemorrhage- a 10 year hospital based study

Authors: Elisabeth Ronne-Engström, Ljubisa Borota, Samuel Lenell, Anders Lewén, Ehab Mahmoud, Christoffer Nyberg, Fartein Velle, Per Enblad

Published in: Acta Neurochirurgica | Issue 1/2024

Abstract

Background

Improved endovascular methods make it possible to treat complex ruptured aneurysms, but surgery is still needed in certain cases. We evaluated the effects on the clinical results of the changes in aneurysm treatment.

Methods

The study cohort was 837 patients with spontaneous subarachnoid hemorrhage (SAH) and one or multiple aneurysms, admitted to Dept of Neurosurgery, Uppsala University Hospital from 2012 to 2021. Demography, location and treatment of aneurysms, neurologic condition at admission and discharge, mortality and last tier treatment of high intracranial pressure (ICP) was evaluated. Functional outcome was measured using the Extended Glasgow Outcome Scale (GOSE) Data concerning national incidences of stroke diseases was collected from open Swedish databases.

Results

Endovascular methods were used in 666 cases (79.6%). In 111 (13.3%) with stents. Surgery was performed in 115 cases (13.7%) and 56 patients (6.7%) had no aneurysm treatment. The indications for surgery were a hematoma (51 cases, 44.3%), endovascular treatment not considered safe (47 cases, 40.9%), or had been attempted without success (13 cases, 11.3%). Treatment with stent devices increased, and with surgery decreased over time. There was a trend in decrease in hemicraniectomias over time. Both the patient group admitted awake (n = 681) and unconscious (n = 156) improved significantly in consciousness between admission and discharge. Favorable outcome (GOSE 5–8) was seen in 69% for patients admitted in Hunt & Hess I-II and 25% for Hunt & Hess III-V. Mortality at one year was 10.9% and 42.7% for those admitted awake and unconscious, respectively.The number of cases decreased during the study period, which was in line with Swedish national data.

Conclusions

The incidence of patients with SAH gradually decreased in our material, in line with national data. The treatment policy in our unit has been shifting to more use of endovascular methods. During the study period the use of hemicraniectomies decreased.

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Title: Trends in incidence and treatments of spontaneous subarachnoid hemorrhage- a 10 year hospital based study
Authors: Elisabeth Ronne-Engström
Ljubisa Borota
Samuel Lenell
Anders Lewén
Ehab Mahmoud
Christoffer Nyberg
Fartein Velle
Per Enblad
Publication date: 01-12-2024
Publisher: Springer Vienna
Keywords: Aneurysm
Aneurysm
Subarachnoid Hemorrhage
Subarachnoid Hemorrhage
Ruptured Aneurysm
Stroke
Intracranial Hypertension
Published in: Acta Neurochirurgica / Issue 1/2024
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-024-06069-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Trends in incidence and treatments of spontaneous subarachnoid hemorrhage- a 10 year hospital based study

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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