Elderly population have a decreased aneurysmal subarachnoid hemorrhage incidence rate than Middle aged population: a descriptive analysis of 8,144 cases in mainland China.

PURPOSE: Rupture of an intracranial aneurysm is a life-threatening acute cerebrovascular event. The purpose of this study was to investigate whether aneurysmal subarachnoid haemorrhage (SAH) incidence rate is higher or lower in elderly population than in middle aged population. MATERIALS AND METHODS: Aneurysmal SAH cases were collected retrospectively from the archives of 21 hospitals in Mainland China. All the cases were collected from September 2016 and backward consecutively for a period of time up to 8 years. SAH was initially diagnosed by brain computed tomography (CT). CT angiography (CTA) or digital subtraction angiography (DSA) was followed and SAH was confirmed to be due to cerebral aneurysm rupture. For cases when multiple bleeding occurred, the age of the first SAH was used in this study. The total incidence from all hospitals at each age group were summed together for females and males respectively; then adjusted by the total population number at each age group for females and males which was from the 2010 population census of the People's Republic of China. RESULTS: In total there were 8,144 cases of intracranial aneurysmal SAH, with 4,861 females and 3,283 males. For females the relative aneurysmal SAH incidence rate started to decrease after around 65 years old, while for males the relative aneurysmal SAH incidence rate started to decrease after around 53 years old. CONCLUSION: Our data tentatively suggest elderly patients may be at a reduced risk of rupture compared with patients who are younger while have similar other risk factors.

A higher aneurysmal subarachnoid hemorrhage incidence in women prior to menopause: a retrospective analysis of 4,895 cases from eight hospitals in China.

BACKGROUND: Subarachnoid hemorrhage (SAH) from a ruptured cerebral aneurysm is a devastating disease. Despite the risk factors, including hypertension, cigarette smoking and alcohol use, are more common in men, aneurysmal SAH belongs to a few diseases which the incidence is higher in women than in men. Sex hormones, especially estrogen, might be protective against this condition. Hormone replacement therapy (HRT) seems to be associated with a reduced risk for aneurysmal SAH. This study aims to know the prevalence of aneurysmal SAH of men and women at different ages. METHODS: The age and gender information of 4,895 case of aneurysmal SAH (3,016 females, 1,879 males) were collected retrospectively from eight institutions in mainland China. The prevalence of aneurysmal SAH of men and women at different ages was analyzed. RESULTS: The data showed women had a higher incidence of aneurysmal SAH than men starting at late thirties, and men might have a higher incidence of aneurysmal SAH than women only before 37-year-old. CONCLUSIONS: Menopause may not be the only dominant factor causing higher incidence of aneurysmal SAH in women than in men.

Diagnosis of male posterior urethral stricture: comparison of 64-MDCT urethrography vs. standard urethrography.

BACKGROUND: There are no reports regarding voiding/retrograde urethrography with 64-row multidetector CT (64-MDCT).To compare the clinical relevance of conventional voiding/retrograde urethrography and 64-MDCT urethrography for the evaluation of male posterior urethral stricture. METHODS: From January to October 2009, 21 men were referred to our institution for the management of posterior urethral stricture. The patients were evaluated with conventional voiding and retrograde urethrography and 64-MDCT urethrography. The patients were examined by open operative intervention which was required in all patients. The radiologic data were compared using the operative findings. RESULTS: 64 MDCT urethrography provided extra clinical data in ten patients. It was superior to conventional urethrography for judging the urethral stricture length in three patients, characterizing the site of urethra-rectal fistula in four patients, and accurately delineating the proximal urethra in six patients. CONCLUSIONS: 64-MDCT urethrography is a promising tool as an alternative to traditional radiographic methods for defining male urethral strictures. It has the advantage of examining patients only in one position, without distortion, and by generating three-dimensional images; it can accurately measure the stricture length, aid in the diagnosis of some associated pathological conditions, such as urethrorectal fistula, and does not expose the physician to radiation.

[Imaging of congenital coronary artery anomalies by dual-source computed tomography angiography].

OBJECTIVE: To investigate the value of dual-source computed tomography (DSCT) angiography in the examination of congenital coronary artery anomalies. METHODS: We retrospectively examined 2530 patients by DSCT angiography between January 2008 and September 2010. Congenital coronary artery anomalies were shown by maximum intensity projection, curved planar reconstruction, and volume rendering. RESULTS: A total of 284 segments with congenital coronary artery anomalies in 225 patients were displayed. The anomalies included those originated from the main branch of coronary artery (n=121, including 35 segments of right coronary artery with high take-off origin and 24 segments of left coronary artery, 17 segments of right coronary artery dated from left aortic sinus, 4 segments of left coronary artery dated from right aortic sinus, 2 segments of left coronary artery dated from posterior aortic sinus, 2 segments of single coronary artery, and 37 segments of para-coronary artery) , coronary artery dysplasia (n=18) , coronary artery fistula (n=9, including 4 segments of right coronary artery-right ventricle fistula, 2 segments of right coronary artery-pulmonary artery fistula, 2 segments of left coronary artery-left ventricle fistula, and 1 segments of left coronary artery-pulmonary artery fistula) , and myocardial bridge (n=136) . In addition, 818 segments of left sinuatrial nodal artery original anomalies in 1720 patients whose sinuatrial nodal artery were well shown. CONCLUSION: DSCT can be helpful in detecting the anomalies of coronary artery.