破裂脳動脈瘤の治療成績 ―札幌圏における北大グループの現況（2003～2007）―

黒田 敏; 石川 達哉; 穂刈 正昭; 中山 若樹; 安田 宏; 吉本 哲之; 牛越 聡; 数又 研; 板本 孝治; 浅野 剛; 青樹 毅; 小林 徹; 瀧川 修吾; 新谷 好正; 高橋 明弘; 寺坂 俊介; 会田 敏光; 馬渕 正二; 野村 三起夫; 斉藤 久壽; 金子 貞男; 岩崎 喜信

doi:10.2335/scs.37.109

Original Articles

Epidemiology, Therapy and Functional Outcome of Aneurysmal Subarachnoid Hemorrhage in Sapporo Between 2003 and 2007: An Area-specific, Group-based Study by Hokkaido University Hospital Group

Satoshi KURODA ^†, Tatsuya ISHIKAWA ^†, Masaaki HOKARI ^†, Naoki NAKAYAMA ^†, Hiroshi YASUDA ^†, Tetsuyuki YOSHIMOTO ^†, Satoshi USHIKOSHI ^†, Ken KAZUMATA ^†, Koji ITAMOTO ^†, Takeshi ASANO ^†, Takeshi AOKI ^†, Tohru KOBAYASHI ^†, Shugo TAKIKAWA ^†, Yoshimasa NIIYA ^†, Akihiro TAKAHASHI ^†, Shunsuke TERASAKA ^†, Toshimitsu AIDA ^†, Shoji MABUCHI ^†, Mikio NOMURA ^†, Hisatoshi SAITO ^†, Sadao KANEKO ^†, Yoshinobu IWASAKI ^†

Author information

Satoshi KURODA ^†
Department of Neurosurgery, Hokkaido University Hospital
Tatsuya ISHIKAWA ^†
Department of Neurosurgery, Hokkaido University Hospital
Department of Surgical Neurology, Research Institute for Brain and Blood Vessels-Akita
Masaaki HOKARI ^†
Department of Neurosurgery, Hokkaido University Hospital
Naoki NAKAYAMA ^†
Department of Neurosurgery, Hokkaido University Hospital
Hiroshi YASUDA ^†
Sapporo Azabu Neurosurgical Hospital
Tetsuyuki YOSHIMOTO ^†
Kashiwaba Neurosurgical Hospital
Satoshi USHIKOSHI ^†
Department of Neurosurgery, Teine Keijinkai Hospital
Ken KAZUMATA ^†
Department of Neurosurgery, Teine Keijinkai Hospital
Koji ITAMOTO ^†
Department of Neurosurgery, Teine Keijinkai Hospital
Takeshi ASANO ^†
Department of Neurosurgery, Hokkaido University Hospital
Takeshi AOKI ^†
Hokkaido Neurosurgical Memorial Hospital
Tohru KOBAYASHI ^†
Department of Neurosurgery, Keiwakai Ebetsu Hospital
Shugo TAKIKAWA ^†
Department of Neurosurgery, Chitose Municipal Hospital
Yoshimasa NIIYA ^†
Department of Neurosurgery, Otaru Daini Municipal Hospital
Akihiro TAKAHASHI ^†
Department of Neurosurgery, Otaru Daini Municipal Hospital
Shunsuke TERASAKA ^†
Department of Neurosurgery, Hokkaido University Hospital
Toshimitsu AIDA ^†
Hokkaido Neurosurgical Memorial Hospital
Shoji MABUCHI ^†
Department of Neurosurgery, Otaru Daini Municipal Hospital
Mikio NOMURA ^†
Department of Neurosurgery, Keiwakai Ebetsu Hospital
Hisatoshi SAITO ^†
Sapporo Azabu Neurosurgical Hospital
Sadao KANEKO ^†
Kashiwaba Neurosurgical Hospital
Yoshinobu IWASAKI ^†
Department of Neurosurgery, Hokkaido University Hospital
Author contributions

†These authors contributed equally: Satoshi KURODA, Tatsuya ISHIKAWA, Masaaki HOKARI, Naoki NAKAYAMA, Hiroshi YASUDA, Tetsuyuki YOSHIMOTO, Satoshi USHIKOSHI, Ken KAZUMATA, Koji ITAMOTO, Takeshi ASANO, Takeshi AOKI, Tohru KOBAYASHI, Shugo TAKIKAWA, Yoshimasa NIIYA, Akihiro TAKAHASHI, Shunsuke TERASAKA, Toshimitsu AIDA, Shoji MABUCHI, Mikio NOMURA, Hisatoshi SAITO, Sadao KANEKO, Yoshinobu IWASAKI

Keywords: cerebral aneurysm, subarachnoid hemorrhage, outcome, multi-center study

JOURNAL FREE ACCESS

2009 Volume 37 Issue 2 Pages 109-115

DOI https://doi.org/10.2335/scs.37.109

Details

Abstract

Recent multi-center studies in Western countries have clarified various aspects of aneurysmal subarachnoid hemorrhage (SAH) as part of evidence-based medicine (EBM). In Japan, however, much less evidence on aneurysmal SAH has been established. In this study, therefore, we prospectively enrolled 836 patients with aneurysmal SAH admitted to Hokkaido University Hospital and its affiliate hospitals in Sapporo area between 2003 and 2007, and analyzed their epidemiology, therapy and functional outcome. Of totally 836 patients, 130 (15.6%) and 214 (25.6%) were categorized into WFNS Grade 4 and 5, respectively. Totally, 689 patients (82.4%) underwent some interventions for ruptured aneurysms, including surgical clipping in 548 patients and endovascular coiling in 121. Of these, favorable functional outcome at 1 month after the onset was obtained in 461 patients (66.9%). Multivariate logistic regression analysis revealed that age, neurological severity, intracerebral hematoma, symptomatic vasospasm, and normal pressure hydrocephalus were independent predictors for poor functional outcome.
The present results suggest the importance of prospective multi-center, cohort or randomized study on aneurysmal SAH in Japan.

Corresponding author

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