Fever after subarachnoid hemorrhage: Risk factors and impact on outcome

AbstractIntroductionAneurysmal subarachnoid hemorrhage is a type of spontaneous hemorrhagic stroke, which is caused by a ruptured cerebral aneurysm. Cerebral vasospasm (CVS) is the most grievous complication of subarachnoid hemorrhage (SAH). The aim of this study was to examine the risk factors that influence the onset of CVS that develops after endovascular coil embolization of a ruptured aneurysm.Materials and methodsThe study was designed as a cross-sectional study. The patients included in the study were 18 or more years of age, admitted within a period of 24 h of symptom onset, diagnosed and treated at a university medical center in Serbia during a 5-year period.ResultsOur study showed that the maximum recorded international normalized ratio (INR) values in patients who were not receiving anticoagulant therapy and the maximum recorded white blood cells (WBCs) were strongly associated with cerebrovascular spasm, increasing its chances 4.4 and 8.4 times with an increase of each integer of the INR value and 1,000 WBCs, respectively.ConclusionsSAH after the rupture of cerebral aneurysms creates an endocranial inflammatory state whose intensity is probably directly related to the occurrence of vasospasm and its adverse consequences.

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The physiopathology of spontaneous hemorrhagic stroke: a systematic review

Reviews in the Neurosciences ◽

10.1515/revneuro-2020-0131 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Alcivan Batista de Morais Filho ◽

Thiago Luis de Holanda Rego ◽

Letícia de Lima Mendonça ◽

Sulyanne Saraiva de Almeida ◽

Mariana Lima da Nóbrega ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Ischemic Stroke ◽

Subarachnoid Hemorrhage ◽

Natural History ◽

Hemorrhagic Stroke ◽

Recent Literature ◽

Clinical Manifestations ◽

The Road ◽

History Of

Abstract Hemorrhagic stroke (HS) is a major cause of death and disability worldwide, despite being less common, it presents more aggressively and leads to more severe sequelae than ischemic stroke. There are two types of HS: Intracerebral Hemorrhage (ICH) and Subarachnoid Hemorrhage (SAH), differing not only in the site of bleeding, but also in the mechanisms responsible for acute and subacute symptoms. This is a systematic review of databases in search of works of the last five years relating to the comprehension of both kinds of HS. Sixty two articles composed the direct findings of the recent literature and were further characterized to construct the pathophysiology in the order of events. The road to the understanding of the spontaneous HS pathophysiology is far from complete. Our findings show specific and individual results relating to the natural history of the disease of ICH and SAH, presenting common and different risk factors, distinct and similar clinical manifestations at onset or later days to weeks, and possible complications for both.

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Ethnic differences in risk factors for subarachnoid hemorrhage

Journal of Neurosurgery ◽

10.3171/jns-07/09/0522 ◽

2007 ◽

Vol 107 (3) ◽

pp. 522-529 ◽

Cited By ~ 7

Author(s):

Vibhor Krishna ◽

Dong H. Kim

Keyword(s):

Risk Factors ◽

Subarachnoid Hemorrhage ◽

Alcohol Consumption ◽

Cohort Studies ◽

Odds Ratio ◽

Case Control ◽

Ethnic Composition ◽

Effect Estimate ◽

Case Control Studies ◽

Current Smoking

Object Studies on risk factors for subarachnoid hemorrhage (SAH) show heterogeneity. For example, hypertension has been found to be a significant risk factor in some studies but not in others. The authors hypothesized that differences in the ethnicity of the populations studied could account for these findings. Methods A metaanalysis was performed using 17 case-control and 10 cohort studies that met specified inclusion criteria. The authors used a random-effect model to calculate the pooled effect estimates for current smoking, hypertension, and alcohol consumption. A meta–regression analysis was performed using the ethnic composition of the study populations as a covariate. Studies were classified as multiethnic or monoethnic, and the pooled effect estimates were compared. Results Analysis of the cohort studies yielded a pooled effect estimate or risk ratio of 3.18 (95% confidence interval [CI] 2.37–4.26) for current smoking, 3.05 (95% CI 2.09–4.44) for hypertension, and 2.46 (95% CI 1.42–4.24) for alcohol consumption at a rate of 150 g/week or more. The results were similar for the case-control studies. For current smoking, the ethnic composition of the study population was a statistically significant predictor of heterogeneity among case-control studies (p < 0.001, even after application of the Bonferroni correction). The risk for SAH among current smokers was higher in multiethnic populations (odds ratio 3.832) than in monoethnic populations (odds ratio 2.487). Conclusions The results of this metaanalysis suggest that differences in susceptibility to the harmful health effects of smoking may be one cause of the observed differences in SAH incidence for different ethnic groups. The role of ethnicity in risk factors for SAH should be considered in future studies.

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