• Abenet Tafesse Mengesha Addis Ababa University


Introduction: Subarachnoid hemorrhage is a devastating neurological emergency associated with high mortality and disability. Little is known about its occurrence and clinical profile in Ethiopia. We, therefore, studied the clinical presentation, causes and outcome of the condition among in a tertiary facility.

Methods: A retrospective analysis of records of patients admitted with the diagnosis of subarachnoid hemorrhage to Tikur Anbassa Specialized Hospital over a period of 12 years, January 2001 to January 2012, was undertaken.

Results: Of 725 patients admitted with the diagnosis of stroke 52 (7.1%) patients were diagnosed to have subarachnoid hemorrhage. Death was registered in 18(34.6%) and disability in seven (13.4%).  Hypertension was the most common risk factor, observed in 36 (69.21 %) of the patients, and seizure disorder and electrolyte abnormalities-hyponatremia were the most common complications.

Conclusion: The outcome of subarachnoid hemorrhage in this study is comparable with reports from elsewhere. A prospective and well-designed epidemiological study is recommended. There is a need to improve the diagnostic and interventional capacity of the hospital.


Key words:  Stroke. Subarachnoid Hemorrhage. Ethiopia


Author Biography

Abenet Tafesse Mengesha, Addis Ababa University

Assistant Professor of Neurolgy

Department of Neurolgy

School of Medicine

College orf Helath Science


Stehbens, WE. Aneurysms and anatomic variation of cerebral arteries. Arch. Pathol1963;75:45.

Sarti, C, Tuomilehto, J, Salomma V, et al. Epidemiology of subarachnoid hemorrhage in Finland from 1983 to 1985. Stroke 1991; 22: 8

Ing All, T, Asplund, K, Mahonen, M, Bonita. A multinational comparison of subarachnoid hemorrhage epidemiology in the WHO MONICA stroke study. Stroke 2000; 31:1045.

Ingall, TJ, Whisnant, JP, Wiebers, DO, O' Fallon, WM. Has there been a decline in subarachnoid hemorrhage mortality? Stroke 1989; 20:718.

Truelsen, T, Bonita, R, Duncan, H, et al. Changes in subarachnoid hemorrhage mortality, incidence, and case fatality in New Zealand between 1981-1983 and 1991 1993. Stroke 1998: 29 2298.

Stegmayr, B, Eriksson, M, Asplund, K. Declining mortality from subarachnoid hemorrhage: changes in incidence and case fatality from 1985 through 2000. Stroke 2003; 35:2059.

Knekt, P, Reunanen, A, Aho, K et al. risk factors for subarachnoid hemorrhage in a longitudinal population study. J Clin Epidemiology 1991; 44:933.

Anderson, CS, Feigin, V, Bennett, D, et al. Active and passive smoking and the risk of subarachnoid hemorrhage: an international population-based case-control study. Stroke 2004; 35:633.

Feigin, VL, rinkel, GJ, Lawes, CM et al. Risk factors for subarachnoid hemorrhage: an updated systematic review of epidemiological studies. Stroke 2005; 36:2773.

Feigin, V, Parag, V, Lawes, CM, et al. Smoking and elevated blood pressure are the most important risk factors for subarachnoid hemorrhage in the Asia-pacific region: an overview of 26 cohorts involving 306, 620 participants. Stroke 2005: 36: 1360.

Okamota, K, Horisawa, R, Kawamura, T, et al. Family history and risk of subarachnoid hemorrhage: a case-control study in Nagoya, Japan. Stroke 2003; 34:422.

Van der Jagt, M, Hasan, D, Bijvoet, HW, et al. Validity of prediction of the site of ruptured intracranial aneurysms with CT. Neurology 1999; 52:34.

Schievink, WI, Schaid, DJ, Rogers, HM, et al. On the inheritance of intracranial aneurysms. Stroke 1994; 25:2028.

Bromberg, JE, Rinkel, GJ, Algra, A, et al. Familial Subarachnoid hemorrhage: distinctive features and patterns of in heritance. Ann Neurol 1995; 38:929.

Longstreth, WT, Nelson, LM, Koepsell, TD, van Belle,G Subarachnoid hemorrhage and hormonal factors in women. A population -based case-control study. Ann Intern med 1994; 121:168.

Gorelick, PB, Hier, DB, Caplan, LR, Langenberg, P. Headache in acute cerebrovascular disease. Neurology 1986; 36:1445.

Schievink, WI. Intracranial aneurysms. N Engl J Med 1997; 336:28.

Polmear, A. Sentinel headaches in aneurismal subarachnoid hemorrhage: what is the true incidence? A systematic review. Cephalagia 2003; 23:935.

Linn, FH, Wijdicks, Af, vander Graaf, Y, et al. Prospective study of sentinel headache in aneurismal subarachnoid hemorrhage. Lancet 1994; 344:590.

Anderson, C Ni Mhurchu, C Scott, D, et al. Triggers of subarachnoid hemorrhage: role of physical exertion, smoking, and alcohol in the Australasian Cooperative Research on Subarachnoid Hemorrhage Study (ACRPSS). Stroke 2003; 34: 1771.

Kassell NF, Sasaki, T Colohan, Ar et al. Cerebral vasospasm following aneurismal subarachnoid hemorrhage. Stroke 1985; 16:562.

Winn, HR, Richardson, Ae Jane, JA. The long-term prognosis in untreated cerebral aneurysms I. The incidence of late hemorrhage in cerebral aneurysms: A 10-year evaluation of 364 patients. Ann Neurol 1977; 1:358.

Inagawa, T, Kamiya, K, Ogasawara, H, Yano, T. Rebleeding of ruptured intracranial aneurysms in the acute stage. SurgNeurol 1987; 28:93.

Naidech, Am, Janjua, N, Kreiter, KT et al. Predictors and impact of aneurysm rebleeding after subarachnoid hemorrhage. Arch Neurol 2005; 62:410.

Haley, EC Jr, Kassell, NF, Toner, HC. A randomized controlled trial of high-dose intravenous nicardipine in aneurismal subarachnoid hemorrhage. A report of Cooperative Aneurysm Study. J Neursosurg 1993; 78:537.

Stroke: Pathophsiology, diagnosis, and management Editors J.P Moh 5th Ed. 2011 page 607

Reniers G, Araya T, Schaap A, Kebede D, Nagelkerke N, countinho R Saunders EJ Monitoring cause-specific adult mortality in developing countries: A comparison of data sources for Addis Ababa and its implications in policy and research. SocSci Med 61; 1952-7




How to Cite




Original Article