Artikel
Gender-related differences in incidence and morbidity of subarachnoid hemorrhage and/or cerebral aneurysms
Geschlechtsspezifische Unterschiede in der Inzidenz und Morbidität von Patienten mit Subarachnoidalblutung und/oder zerebralen Aneurysmen
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Autoren
Veröffentlicht: | 4. Mai 2005 |
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Gliederung
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Objective
Femal gender is a recognized risk factor for occurrence of aneurysmal subarachnoid hemorrhage (SAH). Futhermore it is presumed, that females have a higher risk for development of cerebral vasospasm. The influence of the gender aneurysmal disease is not examined completely.
Methods
Over a period of 5 years from January 2000 to December 2004, 621 with SAH and/or cerebral aneurysms were seen. 540 patients had 677 cerebral aneurysms, they were treated with either microsurgical operation or endovascular coiling. 62 patients (10%) had none aneurysmal SAH. Angiography were not performed 19 patients (3%), because of their poor condition in at admission. Retrospective analysis of differences dependend on gender in admission characteristics, course of illness, and outcome between 365 womens (59%) and 256 men (41%) with cerebral aneurysm and/or SAH.
Results
The female to male ratio was 1,5:1. There was not difference with regard to the age, Fisher and WFNS score by admission. Female patients harbored aneurysms of the ACI more frequently than male patients (70% vs. 30%, p<0,001). Multiple aneurysms were more often in femals (33% vs. 20%, p><0,05). Only clinical vasospasm occure more frequent in womens (OR1,5, p<0,05), angiographical vasospasm and infarction due to vasospasm were comparable in both groups. There was not indeed any difference in the occurrence of the acute hydrocephalus, however the men needed more frequently an shunt (15% vs. 21%, p<0,05). Poor outcome rates at 6 month were not statistically different between the genders after adjustment of the WFNS and Fisher score at admission. The aneurysm of females were coiled frequently (40% vs. 27%, p<0,05), non gender diffenrece in the frequence of surgery.
Conclusions
We have demonstrated gender differences in the development of clinical vasospasm, the incidence of multiple aneurysms, location of aneurysms, and requirement of permanent CSF-shunt. The indentification of these differences is an important subject for futher research.