Original Article

Immunology, Treatment and Public Health Aspects of Subarachnoid Hemorrhage


Background: We aimed to explore the treatment and safety of subarachnoid hemorrhage.

Methods: A retrospective analysis was applied on 137 patients with subarachnoid hemorrhage treated in Binzhou Central Hospital, Bingzhou, China from March 2015 to October 2018.  Seventy cases with interventional embolization of intracranial aneurysms were divided as the observation group, and 67 cases with craniotomy for aneurysm clipping were divided as the control group. The changes of immune globulins before and after surgery, CD4+, CD8+, NIHSS scores, BI scores, the total effective rate of subarachnoid hemorrhage, the total length of postoperative hospital stay and conditions of postoperative complications as well as 30-day survival were compared between the two groups.

Results: The levels of Ig G, Ig M, Ig A, and CD4+ after surgery in the observation group were significantly lower than those before surgery (P<0.05), but significantly higher than those in the control group (P<0.05); the total time of postoperative hospitalization in the observation group was shorter than that in the control group (P<0.05). The incidence of intracranial infection and cerebral vasospasm in the observation group was significantly lower than that in the control group (P<0.05). The NIHSS score of the observation group was significantly lower than that of the control group (P<0.05), and the BI score was significantly higher than that of the control group (P<0.05).

Conclusion: Patients with subarachnoid hemorrhage undergoing interventional embolization of aneurysms can reduce the impact on immune function, decrease the adverse reactions caused by treatments, shorten the length of hospital stay and fully improve the efficacy.

1. Muehlschlegel S (2018). Subarachnoid hem-orrhage. Continuum (Minneap Minn), 24: 1623-1657.
2. Martinez-Perez R, Rayo N, Montivero A, Mura JM (2019). The "Brain Stress Tim-ing" phenomenon and other misinterpre-tations of randomized clinical trial on an-eurysmal subarachnoid hemorrhage. Neu-ral Regen Res, 14: 1364-1366.
3. Hughes JD, Bond KM, Mekary RA, et al (2018). Estimating the global incidence of aneurysmal subarachnoid hemorrhage: a systematic review for central nervous sys-tem vascular lesions and meta-analysis of ruptured aneurysms. World Neurosurg, 115: 430-447.e7.
4. Kanamaru H, Suzuki H (2019). Potential therapeutic molecular targets for blood-brain barrier disruption after subarach-noid hemorrhage. Neural Regen Res, 14: 1138-1143.
5. Gryn K, Schaffhauser-Linzatti MM, Sherif C (2019). Economic Comparison between Endovascular Coiling vs Neurosurgical Clipping for Ruptured and Unruptured Intracranial Aneurysms in Austria. Neuro-surgery, 84: E272-E273.
6. Fang Y, Chen S, Reis C, Zhang J (2018). The Role of Autophagy in Subarachnoid Hemorrhage: An Update. Curr Neuro-pharmacol, 16: 1255-1266.
7. Uozumi Y, Mizobe T, Miyamoto H, et al (2017). Decreased serum sodium levels predict symptomatic vasospasm in pa-tients with subarachnoid hemorrhage. J Clin Neurosci, 46: 118-123.
8. Rose MJ (2011). Aneurysmal subarachnoid hemorrhage: an update on the medical complications and treatments strategies seen in these patients. Curr Opin Anaesthe-siol, 24: 500-507.
9. Taufique Z, May T, Meyers E, et al (2016). Predictors of Poor Quality of Life 1 Year After Subarachnoid Hemorrhage. Neuro-surgery, 78: 256-264.
10. Adeeb N, Griessenauer CJ, Moore J, Staple-ton CJ, et al (2016). Pipeline embolization device for recurrent cerebral aneurysms after microsurgical clipping. World Neuro-surg, 93: 341-345.
11. Lindgren A, Turner EB, Sillekens T, et al (2019). Outcome after Clipping and Coil-ing for Aneurysmal Subarachnoid Hem-orrhage in Clinical Practice in Europe, USA, and Australia. Neurosurgery, 84: 1019-1027.
12. Kühn AL, de Macedo Rodrigues K, et al (2016). Use of the Pipeline embolization device for recurrent and residual cerebral aneurysms: a safety and efficacy analysis with short-term follow-up. J Neurointerv Surg, 9: 1208-1213.
13. O'neill AH, Chandra RV, Lai LT (2016). Safety and effectiveness of microsurgical clipping, endovascular coiling, and stent assisted coiling for unruptured anterior communicating artery aneurysms: a sys-tematic analysis of observational studies. J Neurointerv Surg, 9: 761-765.
14. Zhou Y, Jiang Y, Peng Y, Zhang M (2017). The Quantitative and Functional Changes of Postoperative Peripheral Blood Im-mune Cell Subsets Relate to Prognosis of Patients with Subarachnoid Hemorrhage: A Preliminary Study. World Neurosurg, 108: 206-215.
15. Smith G, Hoh BL, Albayram MS (2019). Anterior spinal artery aneurysm present-ing with spinal subarachnoid hemorrhage in a case of polyarteritis nodosa. Clin Im-aging, 56: 108-113.
16. Beckett JS, Duckwiler GR, Tateshima S, Szeder V, Jahan R, Gonzalez N, Vinuela F (2017). Coil embolization through the Marathon microcatheter: Advantages and pitfalls. Interv Neuroradiol, l 23: 28-33.
17. de Wilde A, Greebe P, Rinkel GJE, Algra A (2019). Stress in Patients With (Un)ruptured Intracranial Aneurysms vs. Population-Based Controls. Neurosurgery, 84: 1065-1071.
18. Sanz-Garcia A, Perez-Romero M, Pastor J, et al (2019). Is it possible to extract intra-cranial pressure information based on the EEG activity? Rev Neurol, 68: 375-383.
19. Das KK, Singh S, Sharma P, et al (2017). Results of Proactive Surgical Clipping in Poor-Grade Aneurysmal Subarachnoid Hemorrhage: Pattern of Recovery and Predictors of Outcome. World Neurosurg, 102: 561-570.
20. Ji C, Chen G (2016). Signaling Pathway in Early Brain Injury after Subarachnoid Hemorrhage: News Update. Acta Neuro-chir Suppl, 121: 123-126.
21. Wu L, Chen G (2016). Signaling Pathway in Cerebral Vasospasm after Subarachnoid Hemorrhage: News Update. Acta Neuro-chir Suppl, 121: 161-165.
22. Lai L T, O’Donnell J, Morgan M K (2013). The risk of seizures during the in-hospital admission for surgical or endovascular treatment of unruptured intracranial aneu-rysms. J Clin Neurosci, 20: 1498-1502.
23. Goertz L, Kasuya H, Hamisch C, et al (2018). Impact of aneurysm shape on morbidity after clipping of unruptured in-tracranial aneurysms. Acta Neurochir (Wien), 160: 2169-2176.
24. Goertz L, Hamisch C, Telentschak S, et al (2018). Impact of Aneurysm Shape on Intraoperative Rupture during Clipping of Ruptured Intracranial Aneurysms. World Neurosurg, 118: e806-e812.
25. Zhang X, Tang H, Huang Q, Hong B, Xu Y, Liu J (2018). Total Hospital Costs and Length of Stay of Endovascular Coiling Versus Neurosurgical Clipping for Un-ruptured Intracranial Aneurysms: System-atic Review and Meta-Analysis. World Neurosurg, 115: 393-399.
26. Darsaut TE, Findlay JM, Magro E, et al (2017). Surgical clipping or endovascular coiling for unruptured intracranial aneu-rysms: a pragmatic randomised trial. J Neurol Neurosurg Psychiatry, 88: 663-668.
27. Fiorella D, Lylyk P, Szikora I, et al (2018). Curative cerebrovascular reconstruction with the Pipeline embolization device: the emergence of definitive endovascular therapy for intracranial aneurysms. J Neu-rointerv Surg, 10: i9-i18.
IssueVol 49 No 4 (2020) QRcode
SectionOriginal Article(s)
Interventional embolization of aneurysms; Subarachnoid hemorrhage; Craniotomy; Clinical efficacy

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How to Cite
ZHAO J, ZHANG J, BU Y, LU W, ZHAO G. Immunology, Treatment and Public Health Aspects of Subarachnoid Hemorrhage. Iran J Public Health. 2020;49(4):673-683.