Subarachnoid Haemorrhage in Malta : Are outcomes adversely affected due to lack of a local neurovascular service?

Objective: This study was performed to assess the incidence, treatment and outcome of non-traumatic Subarachnoid Haemorrhage (SAH) in an island which does not offer a neurovascular service and to determine whether such limitation is associated with a poor outcome. Method: Data of adult patients with a diagnosis of non-traumatic SAH was analysed retrospectively over a two-year period from January 01, 2009 to December 31, 2010. Results: The incidence of SAH in Malta is 3.16 cases per 100 000 population per year. An underlying aneurysm was found in 50% of all cases investigated with angiography. These patients were transported to the United Kingdom for definitve management and the outcome of all these patients at 6 months was excellent. (modified Rankin Scale of 0 or 1). Conclusions: With the incidence of non-traumatic SAH being in the low range, setting up an interventional neuroradiology service in our country to treat aneurysmal SAH would not have the required numbers to maintain expertise and would probably translate into worse clinical outcomes. Despite having geographical and logistic limitations, our standards of care and survival rates are not below those of other international centres. Outcomes for patients with low initial Hunt and Hess scores have not been adversely.peer-reviewe

A 5-year study on the epidemiology and outcome of patients with non-traumatic subarachnoid hemorrhage in Malta

Objective: The aim of this study was to measure the incidence, treatment and outcome of non-traumatic Subarachnoid Haemorrhage (SAH) cases occurring in Malta during the five-year period between January 2011 and December 2015, in order to determine whether the lack of a local neurovascular service is associated with a poor outcome. Method: A retrospective analysis of adult patients (above the age of 16) diagnosed with non-traumatic SAH was carried out. The data collected included a five-year period from January 1st 2011 till December 31st 2015. Results: The incidence of SAH was estimated at 4.04 cases per 100,000 population per year. An underlying aneurysm was found to be the cause of the SAH in 69.1 % of cases investigated with CT angiography or Cerebral Angiography. In these patients, definitive management in the form of coiling or clipping of the aneurysm was carried out in the United Kingdom as part of an agreement between countries, within days. The outcome of these patients measured at 6 months using the Modified Rankin Scale (MRS) was found to be excellent. Conclusion: Despite our geographical and logistical limitations, outcomes of those patients with initial low Hunt and Hess (H+H) scores have not been affected by the lack of a local neurovascular service. Results are comparable to those of other international centres. Further studies looking into feasibility of expanding our local services are being carried out.peer-reviewe

Care in Europe after presenting to the emergency department with a seizure; position paper and insights from the European Audit of Seizure Management in Hospitals

info:eu-repo/semantics/publishe