Joshua D Hughes1, Kamila M Bond2, Rania A Mekary3, Michael C Dewan4, Abbas Rattani5, Ronnie Baticulon6, Yoko Kato7, Hildo Azevedo-Filho8, Jacques J Morcos9, Kee B Park10. 1. Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA. Electronic address: hughes.joshua@mayo.edu. 2. Mayo Clinic School of Medicine, Mayo Clinic, Rochester, Minnesota, USA. 3. Department of Pharmaceutical Business and Administrative Sciences, School of Pharmacy, MCPHS University, Boston, Massachusetts, USA; Department of Neurosurgery, Cushing Neurosurgical Outcomes Center, Brigham and Women's Hospital, Boston, Massachusetts, USA. 4. Department of Global Health and Social Medicine, Harvard Medical School, Global Neurosurgery Initiative, Program in Global Surgery and Social Change, Boston, Massachusetts, USA; Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA. 5. Department of Global Health and Social Medicine, Harvard Medical School, Global Neurosurgery Initiative, Program in Global Surgery and Social Change, Boston, Massachusetts, USA; Meharry Medical College, School of Medicine, Nashville, Tennessee, USA. 6. Department of Neurosurgery, University of the Philippines College of Medicine, Philippine General Hospital, Manila, Philippines. 7. Department of Neurosurgery, Fujita Health University, Nagoya, Japan. 8. Department of Neurological Surgery, Hospital da Restauração, University of Pernambuco, Recife, Brazil. 9. Department of Neurological Surgery, University of Miami, Miami, Florida, USA. 10. Department of Global Health and Social Medicine, Harvard Medical School, Global Neurosurgery Initiative, Program in Global Surgery and Social Change, Boston, Massachusetts, USA.
Abstract
INTRODUCTION: There is increasing acknowledgement that surgical care is important in global health initiatives. In particular, neurosurgical care is as limited as 1 per 10 million people in parts of the world. We performed a systematic literature review to examine the worldwide incidence of central nervous system vascular lesions and a meta-analysis of aneurysmal subarachnoid hemorrhage (aSAH) to define the disease burden and inform neurosurgical global health efforts. METHODS: A systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to estimate the global epidemiology of central nervous system vascular lesions, including unruptured and ruptured aneurysms, arteriovenous malformations, cavernous malformations, dural arteriovenous fistulas, developmental venous anomalies, and vein of Galen malformations. Results were organized by World Health Organization regions. After literature review, because of a lack of data from particular World Health Organization regions, we determined we could only provide an estimate of aSAH. Using data from studies with aSAH and 12 high-quality stroke studies from regions lacking data, we meta-analyzed the yearly crude incidence of aSAH per 100,000 persons. Estimates were generated via random-effects models. RESULTS: From an initial yield of 1492 studies, 46 manuscripts on aSAH incidence were included. The final meta-analysis included 58 studies from 31 different countries. We estimated the global crude incidence for aSAH to be 6.67 per 100,000 persons with a wide variation across WHO regions from 0.71 to 12.38 per 100,000 persons. CONCLUSIONS: Worldwide, almost 500,000 individuals will suffer from aSAH each year, with almost two-thirds in low- and middle-income countries.
INTRODUCTION: There is increasing acknowledgement that surgical care is important in global health initiatives. In particular, neurosurgical care is as limited as 1 per 10 million people in parts of the world. We performed a systematic literature review to examine the worldwide incidence of central nervous system vascular lesions and a meta-analysis of aneurysmal subarachnoid hemorrhage (aSAH) to define the disease burden and inform neurosurgical global health efforts. METHODS: A systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to estimate the global epidemiology of central nervous system vascular lesions, including unruptured and ruptured aneurysms, arteriovenous malformations, cavernous malformations, dural arteriovenous fistulas, developmental venous anomalies, and vein of Galen malformations. Results were organized by World Health Organization regions. After literature review, because of a lack of data from particular World Health Organization regions, we determined we could only provide an estimate of aSAH. Using data from studies with aSAH and 12 high-quality stroke studies from regions lacking data, we meta-analyzed the yearly crude incidence of aSAH per 100,000 persons. Estimates were generated via random-effects models. RESULTS: From an initial yield of 1492 studies, 46 manuscripts on aSAH incidence were included. The final meta-analysis included 58 studies from 31 different countries. We estimated the global crude incidence for aSAH to be 6.67 per 100,000 persons with a wide variation across WHO regions from 0.71 to 12.38 per 100,000 persons. CONCLUSIONS: Worldwide, almost 500,000 individuals will suffer from aSAH each year, with almost two-thirds in low- and middle-income countries.
Authors: Michael Hugelshofer; Raphael M Buzzi; Christian A Schaer; Henning Richter; Kevin Akeret; Vania Anagnostakou; Leila Mahmoudi; Raphael Vaccani; Florence Vallelian; Jeremy W Deuel; Peter W Kronen; Zsolt Kulcsar; Luca Regli; Jin Hyen Baek; Ivan S Pires; Andre F Palmer; Matthias Dennler; Rok Humar; Paul W Buehler; Patrick R Kircher; Emanuela Keller; Dominik J Schaer Journal: J Clin Invest Date: 2019-12-02 Impact factor: 14.808
Authors: Faith C Robertson; Richard Briones; Rania A Mekary; Ronnie E Baticulon; Miguel A Jimenez; Andrew J M Leather; Marike L D Broekman; Kee B Park; William B Gormley; Lynne L Lucena Journal: World Neurosurg X Date: 2019-09-09
Authors: Jefferson Rosi Júnior; João Paulo Mota Telles; Saul Almeida da Silva; Ricardo Ferrareto Iglesio; Mauricio Mandel Brigido; José Guilherme Mendes Pereira Caldas; Manoel Jacobsen Teixeira; Eberval Gadelha Figueiredo Journal: Surg Neurol Int Date: 2019-12-20