Subarachnoid hemorrhage epidemiology and demographics
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Mehrsefat, M.D. [2]
Overview
Epidemiology and demographics
The reported proportion of cases of NASAH that are PM-NASAH varies between 21 to 68 percent [1,2,6,8-11]. In a biracial, population-based, epidemiologic study, the annual rate of PM-NASAH was estimated to be 0.5 per 100,000 persons over 18 years of age [8].
The mean age of occurrence of PM-NASAH in several series was between 50 and 55 years [8,12,13]. However, the age in reported cases ranges from 3 to 72 years old [1,7,14-16]. In contrast to aneurysmal SAH, there is no clear female predisposition for PM-NASAH [8,12,13].
Case-control studies suggest that hypertension and cigarette smoking are risk factors for PM-NASAH, but these appear to be somewhat less prevalent among patients with PM-NASAH compared with patients with aneurysmal SAH [8,17,18]. PM-NASAH is not known to have a familial predisposition; however two cases in first-degree relatives have been described
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The incidence of aneurysmal SAH varies by geographic region. In the United States, the incidence is reportedly between 10 and 15 people per 100,000 population [1,2]. Much lower rates are reported in China (2 cases per 100,000) and in South and Central America (4 per 100,000), while higher rates are reported in Finland and Japan (19 to 23 per 100,000) [3,4].
The mean age at aneurysmal rupture is 55 years [5]. While most aneurysmal SAH occur between 40 and 60 years of age; however young children and the elderly can be affected [6,7]. African Americans appear to be at higher risk than Caucasian Americans [8]. There is a slightly higher incidence of aneurysmal SAH in women, which may relate to hormonal status (see 'Estrogen deficiency' below) [6,9].
Incidence
- The incidence of subarachnoid hemorrhage was estimated 10.5 per 100 000 person annually.[1]
Age
- Subarachnoid hemorrhage (SAH) usually occurs at a relatively young age
- The incidence of aneurysmal subarachnoid hemorrhage (aSAH) increases with age and commonly affects adults ≥50 years of age.[2]
- The mean age of perimesencephalic nonaneurysmal Subarachnoid hemorrhage|subarachnoid hemorrhage (PM-NASAH) occurrence was reported between 50 and 55 years.[3]
Gender
- Women are slightly more affected with aneurysmal Subarachnoid hemorrhage|subarachnoid hemorrhage (SAH) than men (1.24 times higher than in men).[2][4]
- Unlike aneurysmal subarachnoid hemorrhage (SAH), the incidence of perimesencephalic nonaneurysmal subarachnoid hemorrhage (PM-NASAH) does not vary by gender.[3]
Race
- The incidence of aneurysmal subarachnoid hemorrhage (SAH) is higher in Blacks and Hispanics compere to white Americans.[5]
Geographic region
- In the United States, the incidence of subarachnoid hemorrhage (SAH) is 10 to 15 cases per 100,000 population.[6]
- In China, the incidence of aneurysmal subarachnoid hemorrhage (SAH) is 2 cases per 100,000 population.[7]
- In South and Central America, the incidence of subarachnoid hemorrhage (SAH) is 4 cases per 100,000 population.[8]
- In Finland and Japan, the incidence of aneurysmal subarachnoid hemorrhage (SAH) is 19 to 23 cases per 100,000 population. [9]
Case fatality rate
- The 30-day case fatality rate of subarachnoid hemorrhage (SAH]]) is 32,000 cases per 100,000 individuals.[10]
References
- ↑ van Gijn J, Rinkel GJ (2001). "Subarachnoid haemorrhage: diagnosis, causes and management". Brain. 124 (Pt 2): 249–78. PMID 11157554.
- ↑ 2.0 2.1 Rinkel GJ, Djibuti M, Algra A, van Gijn J (1998). "Prevalence and risk of rupture of intracranial aneurysms: a systematic review". Stroke. 29 (1): 251–6. PMID 9445359.
- ↑ 3.0 3.1 Flaherty ML, Haverbusch M, Kissela B, Kleindorfer D, Schneider A, Sekar P; et al. (2005). "Perimesencephalic subarachnoid hemorrhage: incidence, risk factors, and outcome". J Stroke Cerebrovasc Dis. 14 (6): 267–71. doi:10.1016/j.jstrokecerebrovasdis.2005.07.004. PMC 1388255. PMID 16518463.
- ↑ de Rooij NK, Linn FH, van der Plas JA, Algra A, Rinkel GJ. Incidence of subarachnoid haemorrhage: a systematic review with emphasis on region, age, gender and time trends. J Neurol Neurosurg Psychiatry. 2007;78:1365–1372.
- ↑ Broderick JP, Brott T, Tomsick T, Huster G, Miller R (1992). "The risk of subarachnoid and intracerebral hemorrhages in blacks as compared with whites". N Engl J Med. 326 (11): 733–6. doi:10.1056/NEJM199203123261103. PMID 1738378.
- ↑ Shea AM, Reed SD, Curtis LH, Alexander MJ, Villani JJ, Schulman KA (2007). "Characteristics of nontraumatic subarachnoid hemorrhage in the United States in 2003". Neurosurgery. 61 (6): 1131–7, discussion 1137-8. doi:10.1227/01.neu.0000306090.30517.ae. PMID 18162891.
- ↑ Ingall T, Asplund K, Mahonen M, Bonita R. A multinational com- parison of subarachnoid hemorrhage epidemiology in the WHO MONICA stroke study. Stroke. 2000;31:1054 –1061.
- ↑ de Rooij NK, Linn FH, van der Plas JA, Algra A, Rinkel GJ (2007). "Incidence of subarachnoid haemorrhage: a systematic review with emphasis on region, age, gender and time trends". J Neurol Neurosurg Psychiatry. 78 (12): 1365–72. doi:10.1136/jnnp.2007.117655. PMC 2095631. PMID 17470467.
- ↑ Ingall T, Asplund K, Mähönen M, Bonita R (2000). "A multinational comparison of subarachnoid hemorrhage epidemiology in the WHO MONICA stroke study". Stroke. 31 (5): 1054–61. PMID 10797165.
- ↑ Feigin, Valery L., et al. "Stroke epidemiology: a review of population-based studies of incidence, prevalence, and case-fatality in the late 20th century." The Lancet Neurology 2.1 (2003): 43-53.