Hemorrhagic stroke epidemiology and demographics
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Mehrsefat, M.D. [2]
Overview
Overview
In 2013, the prevalence of hemorrhagic stroke was estimated at 116.6 cases per 100,000 individuals.[1] Intracerebral hemorrhage (ICH) constitutes 10,000 to 15,000 cases per 100,000 individuals with all kind of strokes and has a higher risk of morbidity and mortality than cerebral infarction or subarachnoid hemorrhage.
| Epidemiology | Intracerebral hemorrhage | Subarachnoid hemorrhage |
|---|---|---|
| Incidence.[2][3] |
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| Age[4][5] |
|
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| Gender[5][6] |
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| Race[7][8] |
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| Case fatality rate[9][10] |
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Epidemiology and demographics
Epidemiology and demographics
Prevalence
In 2013, the prevalence of hemorrhagic stroke was estimated at 116.6 cases per 100,000 individuals.[1]
Incidence
In 2013, the age-adjusted incidence of hemorrhagic stroke was estimated 54.3 cases per 100,000 individuals.[1]
Intracerebral hemorrhage
- The overall incidence of intracerebral hemorrhage (ICH) ranges from 12 to 31 per 100,000 population.[2]
Subarachnoid hemorrhage
- The incidence of subarachnoid hemorrhage was estimated 10.5 per 100 000 person years.[3]
Age
Intracerebral hemorrhage
- The incidence of intracerebral hemorrhage (ICH) increases with age, after age 35 every 10 years, the risk of having ICH is getting doubled.[4]
- Primary lobar hemorrhages, due to cerebral amyloid angiopathy, are typically seen in elderly. Younger patients may also develop lobar hemorrhages, but in such cases they usually have an underlying lesion such as cerebral arteriovenous malformation (AVM).[11]
Subarachnoid hemorrhage
- Subarachnoid hemorrhage (SAH)usually occurs at a relatively young age
- The incidence of aneurysmal subarachnoid hemorrhage (aSAH) increases with age and commonly affects adults ≥50 years of age.[5]
Gender
Intracerebral hemorrhage
The prevalence and incidence of intracerebral hemorrhage does not vary by gender.[6]
Subarachnoid hemorrhage
- Women are slightly more affected with aneurysmal subarachnoid hemorrhage (SAH) than men (1.24 times higher than in men).[5][12]
Race
intracerebral hemorrhage
- The incidence of intracerebral hemorrhage is the highest in Asians, follow by blacks, and is the lowest in whites.
- In African Americans, the incidence of hemorrhagic stroke (intracerebral hemorrhage) is 48 cases per 100,000 persons.
- In whites, the incidence of hemorrhagic stroke (intracerebral hemorrhage) is 48 cases per 100,000 persons. [7]
- The incidence of Intracerebral hemorrhage is higher in Mexican Americans than non-Hispanic whites.[13]
Subarachnoid hemorrhage
- Subarachnoid hemorrhage usually affects individuals of African Americans populations.[8]
- The incidence of aneurysmal subarachnoid hemorrhage (SAH) is higher in Blacks and Hispanics compere to white Americans.
Geographic region
Subarachnoid hemorrhage (SAH)
- In the United States, the incidence of aneurysmal subarachnoid hemorrhage (SAH) is 10 to 15 cases per 100,000 population.[14]
- In China, the incidence of aneurysmal subarachnoid hemorrhage (SAH) is 2 cases per 100,000 population.[15]
- In South and Central America, the incidence of aneurysmal subarachnoid hemorrhage (SAH) is 4 cases per 100,000 population.[16]
- In Finland and Japan, the incidence of aneurysmal subarachnoid hemorrhage (SAH) is 19 to 23 cases per 100,000 population. [17]
Case fatality rate
intracerebral hemorrhage
- The 30-day case fatality rate of intracerebral hemorrhage (ICH) ranges from 37,000 to 52,000 cases per 100,000 individuals.[9][10]
- Death at 1 year for intracerebral hemorrhage (ICH) varies by hemorrhage location:[18]
- Brain steam 65,000 cases per 100,000 individuals
- Lobar ICH 57,000 cases per 100,000 individuals
- Deep ICH 50,000 cases per 100,000 individuals
- Cerebellar ICH 42,000 cases per 100,000 individuals
Subarachnoid hemorrhage
- The 30-day case fatality rate of subarachnoid hemorrhage (SAH) is 32,000 cases per 100,000 individuals.[19]
References
References
- ↑ 1.0 1.1 1.2 Global Burden of Disease Study 2013 Collaborators (2015). “Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013”. Lancet. 386 (9995): 743–800. doi:10.1016/S0140-6736(15)60692-4. PMC 4561509. PMID 26063472.
- ↑ 2.0 2.1 Gebel JM, Broderick JP (2000). “Intracerebral hemorrhage”. Neurol Clin. 18 (2): 419–38. PMID 10757834.
- ↑ 3.0 3.1 van Gijn J, Rinkel GJ (2001). “Subarachnoid haemorrhage: diagnosis, causes and management”. Brain. 124 (Pt 2): 249–78. PMID 11157554.
- ↑ 4.0 4.1 Stein M, Misselwitz B, Hamann GF, Scharbrodt W, Schummer DI, Oertel MF (2012). “Intracerebral hemorrhage in the very old: future demographic trends of an aging population”. Stroke. 43 (4): 1126–8. doi:10.1161/STROKEAHA.111.644716. PMID 22282880.
- ↑ 5.0 5.1 5.2 5.3 Rinkel GJ, Djibuti M, Algra A, van Gijn J (1998). “Prevalence and risk of rupture of intracranial aneurysms: a systematic review”. Stroke. 29 (1): 251–6. PMID 9445359.
- ↑ 6.0 6.1 van Asch CJ, Luitse MJ, Rinkel GJ, van der Tweel I, Algra A, Klijn CJ (2010). “Incidence, case fatality, and functional outcome of intracerebral haemorrhage over time, according to age, sex, and ethnic origin: a systematic review and meta-analysis”. Lancet Neurol. 9 (2): 167–76. doi:10.1016/S1474-4422(09)70340-0. PMID 20056489.
- ↑ 7.0 7.1 Flaherty ML, Woo D, Haverbusch M, Sekar P, Khoury J, Sauerbeck L; et al. (2005). “Racial variations in location and risk of intracerebral hemorrhage”. Stroke. 36 (5): 934–7. doi:10.1161/01.STR.0000160756.72109.95. PMID 15790947.
- ↑ 8.0 8.1 Broderick JP, Brott T, Tomsick T, Huster G, Miller R (1992). “The risk of subarachnoid and intracerebral hemorrhages in blacks as compared with whites”. N Engl J Med. 326 (11): 733–6. doi:10.1056/NEJM199203123261103. PMID 1738378.
- ↑ 9.0 9.1 Dennis, Martin S., et al. “Long-term survival after first-ever stroke: the Oxfordshire Community Stroke Project.” Stroke 24.6 (1993): 796-800.
- ↑ 10.0 10.1 Kleindorfer D., Broderick J., Khoury J., et al: The unchanging incidence and case-fatality of stroke in the 1990s: a population-based study. Stroke 2006; 37: pp. 2473-2478
- ↑ Falcone GJ, Biffi A, Brouwers HB, Anderson CD, Battey TW, Ayres AM; et al. (2013). “Predictors of hematoma volume in deep and lobar supratentorial intracerebral hemorrhage”. JAMA Neurol. 70 (8): 988–94. doi:10.1001/jamaneurol.2013.98. PMC 3808840. PMID 23733000.
- ↑ de Rooij NK, Linn FH, van der Plas JA, Algra A, Rinkel GJ. Incidence of subarachnoid haemorrhage: a systematic review with emphasis on region, age, gender and time trends. J Neurol Neurosurg Psychiatry. 2007;78:1365–1372.
- ↑ Morgenstern LB, Smith MA, Lisabeth LD, Risser JM, Uchino K, Garcia N; et al. (2004). “Excess stroke in Mexican Americans compared with non-Hispanic Whites: the Brain Attack Surveillance in Corpus Christi Project”. Am J Epidemiol. 160 (4): 376–83. doi:10.1093/aje/kwh225. PMC 1524675. PMID 15286023.
- ↑ Shea AM, Reed SD, Curtis LH, Alexander MJ, Villani JJ, Schulman KA (2007). “Characteristics of nontraumatic subarachnoid hemorrhage in the United States in 2003”. Neurosurgery. 61 (6): 1131–7, discussion 1137-8. doi:10.1227/01.neu.0000306090.30517.ae. PMID 18162891.
- ↑ Ingall T, Asplund K, Mahonen M, Bonita R. A multinational com- parison of subarachnoid hemorrhage epidemiology in the WHO MONICA stroke study. Stroke. 2000;31:1054 –1061.
- ↑ de Rooij NK, Linn FH, van der Plas JA, Algra A, Rinkel GJ (2007). “Incidence of subarachnoid haemorrhage: a systematic review with emphasis on region, age, gender and time trends”. J Neurol Neurosurg Psychiatry. 78 (12): 1365–72. doi:10.1136/jnnp.2007.117655. PMC 2095631. PMID 17470467.
- ↑ Ingall T, Asplund K, Mähönen M, Bonita R (2000). “A multinational comparison of subarachnoid hemorrhage epidemiology in the WHO MONICA stroke study”. Stroke. 31 (5): 1054–61. PMID 10797165.
- ↑ Woo, Daniel, and Joseph P. Broderick. “Spontaneous intracerebral hemorrhage: epidemiology and clinical presentation.” Neurosurgery clinics of North America 13.3 (2002): 265-279.
- ↑ Feigin, Valery L., et al. “Stroke epidemiology: a review of population-based studies of incidence, prevalence, and case-fatality in the late 20th century.” The Lancet Neurology 2.1 (2003): 43-53.
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