Pattern of non-traumatic subarachnoid hemorrhage at the Kenyatta National Hospital a descriptive cross sectional study
Wekesa, D V
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This study was designed to describe the pattern of non-traumatic subarachnoid hemorrhage (SAH) at the Kenyatta National hospital (KNH). A prospective analysis of consecutive patients who had SAH and admitted at the KNH between December 2010 and March 2011 was performed. Data on causes, pattern, and socio-demographic characteristics was collected using a questionnaire administered to the patients who met the inclusion criteria. The data collected was entered and analyzed using Statistical Package for Social Sciences (SPSS) for Windows® version 16.0. A total of 55 patients with SAH were recruited in the study. More females suffered from SAH than men, with a male: female ratio of 1: 1.1. The mean age was 47.6 years with a modal age group being 41-50 years, females however had an earlier peak than males, 41- 50 years and 51-60 years respectively. Three quarters (75%) of patients with SAH were between 21-60 years. Headache was the commonest symptom (91 %) in patients with SAH. Facial nerve palsy was the commonest of the cranial nerve palsies (75%) observed in these patients. The least common presentation was hemi-neglect found in 2% of cases. Majority of the patients in the study were on nimodipine. Forty ope percent (41 %) of the females were on oral contraceptive pills, 15% of all patients were cigarette smokers, while alcohol consumption was observed in 31 % of the patients. No patient in the series was confirmed to be on illicit drugs. Twenty nine percent (29%) of patients were confirmed to have had aneurysmal SAH. All the aneurysms in this series were observed in the anterior circulation, with the anterior communicating artery aneurysms being the commonest at 33.3%, followed by middle cerebral artery (MeA) at 26.6%. Arterio-venous malformations were observed in only 4% of cases. Fifty one percent (51%) of the patients were known hypertensives prior to the SAH episode. Sixty percent (60%) of patients presented with elevated blood pressure with no prior history of hypertension. Sixty six percent (66%) of patients presented with Glasgow Coma Scale (GCS) between 7-14. Thirty eight percent (38%) presented in World Federation ofNeurosurgeons (WFNS) gradel.