Clinical Profile, Risk Factors and Outcome Assessment of Aneurysmal Subarachnoid Hemorrhage (SAH) Patients: A Multicenter Study in Bangladesh

The vast majority of the literature on aneurysmal Subarachnoid Hemorrhage (aSAH) is flawed by the homogeneity of Caucasian population in western based studies. There is dearth of such studies in the Indian Subcontinent which has different demographics, cultural differences and health problems, which we aim to explore with this study. This cross-sectional observational study on aSAH patients was conducted in 3 different hospitals in Bangladesh from 2016 to 2017. A total of 45 adult patients who fulfilled the selection criteria were enrolled in this study. Patients with confirmed SAH from ruptured cerebral aneurysm by various cerebral angiographic studies were evaluated for clinical profile, risk factors and outcome assessment. Headache (100%) was the most common presenting symptom. We found female predominance (62%), the age group with maximum number of patients was 41-60 years (60%). The most common clinical risk factor was hypertension (55%). Half of the patients have size of the ruptured cerebral aneurysm dome <7 mm. The most common location of the aneurysm was anterior communicating artery (51%). Statistically significant association was found between the Glasgow Outcome Scale at the time of discharge from the hospital with the Fischer Grading of SAH (p value of 0.03). Our study comprising Bangladeshi patients with aSAH had certain similarities and dissimilarities with predominantly white based western studies. Half of the patients in our study had small sized aneurysm which are known to rarely rupture, should provoke new thoughts about their management among neurosurgeons