The challenge of subarachnoid haemorrhage in a regional teaching hospital in Nigeria

• Published in: International Journal of Medicine and Health Development Vol. 13; no. 1; pp. 13 - 17
• Main Authors: Ikenna O Onwuekwe, Austin C Nwabueze, Emmanuel N Aguwa
• Format: Journal Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 01.01.2008
• Subjects: challenge; nigeria; subarachnoid haemorrhage
• ISSN: 2635-3695

Background: Aneurysmal subarachnoid haemorrhage remains a significant cause of morbidity and mortality from stroke in Africans. In many parts of Nigeria it is largely underdiagnosed. Literature is scanty for this condition in the South East of Nigeria especially for the last two decades. Aims: To determine the case spectrum of subarachnoid haemorrhage, particularly of the aneurysmal type, in Enugu, South East Nigeria. Methods: A retrospective study was done of patients admitted into the medical wards of the University of Nigeria Teaching Hospital Enugu Nigeria with a clinical diagnosis of stroke between January 1980 and December 1999, a twenty year period. Case records of suspected and confirmed subarachnoid haemorrhage cases were identified and relevant data obtained. Results: Out of a total of 450 patients admitted with stroke, only 38 were clearly identified to have haemorrhagic stroke. Of these, 22 patients were managed as subarachnoid haemorrhage representing 58% of the haemorrhagic stroke patients and 4.9% of the total stroke patients. Most of the stroke patients, 337 in all (74.9%), were not classified as being either ischaemic or haemorrhagic in nature. There were more female than male patients with subarachnoid haemorrhage and the ages ranged from the second decade to the ninth decade of life. Only 5 of the 22 patients with subarachnoid haemorrhage had proven ruptured aneurysms as the cause. Systemic hypertension was a significant finding in 59% of the patients with subarachnoid haemorrhage. Conclusion: There is clear evidence that majority of cases of subarachnoid haemorrhage remain unrecognized in Nigeria. Non recognition may mean unnecessarily high disability and deaths from a condition which with modern neurological care maybe significantly ameliorated resulting in improved quality of life for the affected patients.