Spontaneous subarachnoid haemorrhage:: A study of 462 patients

Aims. To describe the demographic characteristics of patients with spontaneous subarachnoid haemorrhage (SAH) in our population and to compare the endovascular and surgical treatment of intracranial aneurysms. Patients and methods. We conducted a retrospective study of 462 patients who were admitted to the Hospital Universitario La Fe in Valencia between April 1997 and March 2005. Results. The mean age was 56.8 +/- 14.8 years and 55.8% of the patients were females. The risk factors were: arterial hypertension, 40.3%: smoking, 32.7%; dyslipidemia, 16.0% ; diabetes mellitus, 10.6%; alcoholism. 6.7%. A cerebral arteriography was performed in 369 patients and intracranial aneurysms were detected in 246 of them. Aneurysms were treated by embolisation in 62.6% of cases and by surgery in 22%. On comparing the embolisation and surgery groups, there were non-significant differences in the rates of complications. Infections were peresent in 21.9% of patients in the embolisation group versus 10.2% in the surgery group; epileptic seizures 6.1% versus 8%; hydrocephalus 2.7% versus 4%; rebleeding 4.1% versus 10.2%; clinical casospasm 8.9% versus 6.1%. The rate of sequelae on discharge (a score on the modified Rankin Scale > 3) was 13.7% among surviving patients in the embolisation group and 15.5% in the group that had undergone surgery. The mortality rates in the two groups were 10.3 and 10%, respectively. Overall mortality rate was 30.1%. Conclusions. The presentation and course of SAH in our population follow a pattern that is similar to those reported in other countries. No differences in morbidity and mortality were detected between the endovascular and surgical treatment of ruptured intracranial aneurysms.