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New Study on Non Aneurysmal SAH


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http://jnnp.bmj.com/content/early/2011/04/06/jnnp.2010.239335.full

This study was just released last month. It investigates non aneurysmal SAH both short term and long term. The data includes and combined both perimesencephalic bleeds and diffuse patterns bleeds.

Some interesting things -

Known aneurysmal SAH has roughly a 50% mortality whereas non aneurysmal SAH has a mortality of about 4-10%

Rebleeding in aneurysmal patients carries a mortality of 50-70% whereas rebleeding in non aneurysmal patients is about 5-15%

For non aneurysmal patients, the rebleed risk after one year is less than 1%

Long term morbidity for aneurysmal patients is about 60-70% whereas non aneurysmal patients its about 15%

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Mmm having read through it briefly - it would have held more ground with the statistics had it been a world wide study - it doesn't appear to have taken more than Finland and parts of the USA into account.

As a Social Scientist I always look for quantitive and qualititive statistics when reading reports where statistics seem to play a huge part.

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yeah i guess one problem is there arent very many people who are angio negative so it makes large studies at a single institution over many years difficult. alot of data is pooled from other studies.

given the new technology in the last 10 years apparently fewer cases of angio negative are occuring, thus resulting in fewer missed aneurysms and therefore less rebleeding and mortality/morbidity.

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Not sure I understood the brain jargon :oops:

Patients with anni bleed - long term survival rate 60-70%? Hope I mis-understood, that's a bit scary.......

I believe that figure stated differently is : Of all people who survive aneurysmal rupture, about 60-70% have long term morbidity and/or dont make complete recoveries.

Its kind of a broad term.

The figure of 50-70% is for people who have aneurysmal rupture and THEN rebleeding, the mortality upon rebleeding is 50-70%

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Personally I dont go by facts and figues because if we'd went by what the medical people said then for me I would be the same now as I was at 3months, (which would be 80% disabled & 20% abled)....

Edited by Louise
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Surely the "morbidity" rate has to be in relation to the severity of the bleed - otherwise its like saying everyone who has a car crash is going to lose a limb due to injuries - the outcome depends on the severity of the event.

At the end of the day - we're all different and we all react and recover in different ways and at different rates - these statistical studies really aren't worth the paper they're written on.

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They ought to do a study on how many of us actually get referred straight away to hospital at our 1st visit to the Doctor and onset of SAH? ... as there's not many of us on here that haven't been fobbed off, once, twice or even three times and sent home and then blue lighted into hospital in a very poor condition. May be that explains the extremely high mortality rate and poor recovery rate when it comes to aneurysmal SAH....as if we were treated earlier with surgical intervention, then the diabolical survival statistics would be a whole lot better!

It doesn't matter how many studies are done, medical papers written, swift diagnosis and recognition of a SAH by a GP/hospital staff is the crucial point and until they start to get their act sorted out and diagnosing and referring people immediately for a scan, then the morbidity rate for aneurysmal SAH will always remain unacceptably high.... May be this point should be factored into medical papers when it comes down to survival rates, as we know that many can survive and have a good outcome, if they're treated promptly.

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Surely the "morbidity" rate has to be in relation to the severity of the bleed - otherwise its like saying everyone who has a car crash is going to lose a limb due to injuries - the outcome depends on the severity of the event.

I am trying to find the study right now but one was done to asses that similiar thesis.

Basically they wanted to study volume of blood and the effects in known aneurysmal cases and known non aneurysmal. The conclusion was that even when NON aneurysmal patients had a greater volume of blood vs aneurysmal rupture patients, they experienced far fewer complications and disabilities.

That has been a major factor in the belief that non aneurysmal bleeds are NOT from an arterial source but rather a low presure vein.

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That would make more sense - kind of the rate of morbidity from a paper cut as opposed to losing a limb in accident :roll:

I was coiled and was up and walking a day later and discharged from hospital four days later and I now do not feel any after affect of the SAH and the artery wall at the base of the two annis has healed perfectly. Going on Karen's theory I was diagnosed immediately and therefore that probably saved my life rather than the cause of the bleed being fro an anuersym.

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I was lucky to have a paramedic who recognized my horrible headache and stiff neck as aneurysm symptoms immediately. I didn't have an aneurysm but it was his quick thinking that got me admitted to the Emergency room and pointed in the right direction immediately. I agree that that survival rates would be far better if less people were turned away with 'migraine' by GP's and Emergency room staff.

I had an interesting conversation with my GP today. She had asked me to read 'My Stroke of Insight' by Jill Bolte Taylor. Great read! Jill had an AVM. Even though her bleed was huge compared to mine and her experience was 10 times worse than mine I could still relate to much of what she wrote about. My doc and I talked about 'what is a stroke'. She believes that the traditional stroke is when the blood is stopped from getting to all parts of the brain and that a hemorrhagic stroke is a bleed from an artery. She believes that what I had, she describes as a leak from a vein is not a stroke. I asked her about AVM and she wasn't as sure at that point. It really is confusing. My doc has been great, the point of this is that even the medical community has a tough time distinguishing what is stroke and what isn't.

Sandi K.

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http://jnnp.bmj.com/content/early/2011/04/06/jnnp.2010.239335.full

This study was just released last month. It investigates non aneurysmal SAH both short term and long term. The data includes and combined both perimesencephalic bleeds and diffuse patterns bleeds.

Some interesting things -

Known aneurysmal SAH has roughly a 50% mortality whereas non aneurysmal SAH has a mortality of about 4-10%

Rebleeding in aneurysmal patients carries a mortality of 50-70% whereas rebleeding in non aneurysmal patients is about 5-15%

For non aneurysmal patients, the rebleed risk after one year is less than 1%

Long term morbidity for aneurysmal patients is about 60-70% whereas non aneurysmal patients its about 15%

I've read this paper twice and can't find anything about 'long term morbidity' for aneurysmal patients. (but it is more than likely I have missed this) As far as I am aware the long term outcome for aneurysmal patients who have been coiled or clipped is extremely good. My family were told that if I didn't have the coiling then the chance of re-bleed would be 80%. After successful coiling there was no chance of re-bleed.

I think the study is a small one and by there own admission is flawed as they only re examined 33% of the original number of patients, not enough.

The part of the study that interested me was the mention of micro aneurysms. Could it be that all bleeds are maybe caused by aneurysms and that they are so small that they can't be picked up with our technology...yet..? Or is it a case that very small capillaries and viens sometime rupture for no reason? I've got so much to learn about all of this.

Karen I agree with what you say about the initial diagnosis, the ambulance crew in my case quickly suspected a SAH and because my bleed was a bad one, their quick thinking helped save my life.

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Yes, but the problem is his studies aren't wide scale enough. For any statitics to be taken seriously the study has to be world wide surely - different procedures, aftercare and diagnosis all play a part and unfortunately this study seems to be small fry in a world wide ocean.

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I always thought morbid meant miserable or looking on the dark side of life......!!!!

All I know is I had anni/ SAH.....and if I hadn't caught so many germs in hospital I would have had

shunt fitted earlier..... and been more like my old self.

Well guess it gave my hubby a break (Joke)

I feel well in myself apart from getting fat so I start diet and will smile everytime I pass the chocs sob sob

Anyone who has had anni keep smiling and sing BE HAPPY ! !

Being happy and smiling will keep us winners no matter what life throws our way so after 3

I want to see you all smile...a 1...a 2....a 3

SMILE !!!!!

regards

WinB

Edited by Winb143
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Well said Win - surely we don't really need or want all of these unnecessary statistics - if stats were to be believed then this country shouldn't be in the state it's in.

Let's not forget guys - this forum/site is for supporting our fellow sufferers, not trying to scare the be-jesus out of them.

Keep smiling everyone - laughter is the best medicine not reading doom and gloom stats.

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I've been lurking in this thread up to now. I've read lots of statistics from every source imaginable. Some interesting and probably true, some questionable and based on the slimest of evidence.

Win and Sami, you're right. They can make me a statistic when I'm gone. Until then, I'm just going to enjoy life and make the most of everything I can, because statistically, I have a 2 in a million chance of being run over and killed by a bus (so I'm told)... unless I decide to wander around China with my iPod :D

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This thread seems to have started to unsettle and worry some recovering members re: morbidity statistics.

Whatever your views are on medical papers, they are often very hard to read, to absorb (especially people with short term memory problems) and can often quote the most ghastly of statistics and can scare the pants off you as you start to recover and try re-build your life.

The thought of "will it happen to me again" is always uppermost in many members thoughts and it's a hard one to lose and takes time. This site is here to offer recovery support and positivity from members that have made the same journey and to enable survivors to see that it is possible to move forward and to live as normal a life as possible, without living with constant fear for the future.

I would like to thank everyone that has participated in this thread, debated and expressed their views, but for reasons of sensitivity, this thread will now be closed.

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