Ramnarayan Ramachandran, Anto Dominic, Alapatt Jacob
Department of Neurosurgery, New Hope Hospital, Chennai, Tamil Nadu, India.
Department of Neurosurgery, Pushpagiri Institute of Medical Sciences, Thiruvalla, Kerala, India.
Asian J Neurosurg. 2018 Jul-Sep;13(3):669-673. doi: 10.4103/ajns.AJNS_301_16.
The incidence of aneurysmal subarachnoid hemorrhage (SAH) reported in the literature has been very variable. Many authors have proposed a geographical variation in incidence, but others have dismissed this as being due to insufficient pickup rate. In India also, these arguments abound. Our aim was to find out if geographical variations exist in the incidence of aneurysmal SAH and whether the incidence of aneurysmal SAH was truly less in India as compared to the literature.
The data from 182 consecutive cases of SAH admitted to this institution between March 1999 and July 2003 were used for this study.
There were 84 females and 98 males in this study. More than half of the patients were hypertensive. Four-vessel angiogram was done in 113 patients, of whom sixty-nine were normal. Of the patients with hypertension, 92% had angiogram done and was normal in 65% of cases.
This study from a large general hospital in South India shows that the incidence of aneurysmal rupture as a cause of SAH is much less in India and probably in the Indian subcontinent in comparison with the western literature thus demonstrating geographical variations in the incidence of aneurysmal SAH. It is concluded that aneurysms as a cause of SAH are still less in India and that we are not missing anything. This study is intended to help target scarce, expensive resources toward more common pathologies.
文献报道的动脉瘤性蛛网膜下腔出血（SAH）发病率差异很大。许多作者提出发病率存在地域差异，但也有其他人认为这是由于检出率不足所致。在印度，这类争论也很多。我们的目的是查明动脉瘤性SAH的发病率是否存在地域差异，以及与文献相比，印度动脉瘤性SAH的发病率是否确实较低。
本研究使用了1999年3月至2003年7月间本院收治的182例连续SAH病例的数据。
本研究中有84名女性和98名男性。超过一半的患者患有高血压。113名患者进行了四血管造影，其中69名结果正常。在高血压患者中，92%进行了血管造影，65%的病例结果正常。
这项来自印度南部一家大型综合医院的研究表明，与西方文献相比，印度以及可能整个印度次大陆因动脉瘤破裂导致SAH的发病率要低得多，从而证明了动脉瘤性SAH发病率存在地域差异。得出的结论是，在印度，动脉瘤作为SAH的病因仍然较少，而且我们没有遗漏任何情况。本研究旨在帮助将稀缺、昂贵的资源用于更常见的病症。
