Characteristics and causes of spontaneous subarachnoid hemorrhage in patients at the Hospital Escuela, Honduras

Introduction: subarachnoid hemorrhage (SAH) is blood in the subarachnoid space. It can be spontaneous or post-traumatic, and its morbidity and mortality are high. The majority of spontaneous SAH cases are due to aneurysmal rupture. In Honduras, information regarding the epidemiological and clinical profile of patients with spontaneous SAH is limited, which hinders prevention and treatment efforts. Access to this information will provide elements for public health intervention strategies. Method: this descriptive observational study collected data from patients over 18 years old diagnosed with spontaneous SAH admitted to the Escuela Hospital from 2020 to 2024. With a population of 360 patients, a recommended sample of 186 individuals was obtained, resulting in 70 complete records for analysis. A data collection instrument was applied to these records, and the data were processed in EPI-INFO 7.5.1.2. Results: of the evaluated cases, 65,7% were women and 34,3% were men. The average age of presentation was 53,7 years. The majority were housewives, accounting for 50,0%. The most frequent associated conditions were hypertension at 60,0%, idiopathic cases at 28,6%, and smoking at 14,3 %. The clinical and imaging characteristics were as follows: 30,0% were admitted with a Glasgow score of 15 and 34,3% with a Hunt and Hess grade of III, 52,9% had a Fisher grade of IV, and 18,6% had an angiographic result indicative of a ruptured aneurysm of the middle cerebral artery. Regarding complications, 35,7% presented none, 20,0% experienced vasospasm, and 12,9% had hydrocephalus. The mortality rate was 2,9%. Conclusions: spontaneous subarachnoid hemorrhage predominated in the female sex (65,7%), with an average age of presentation of 53,7 years. The main associated condition was hypertension (60%). The primary angiographic diagnoses were: ruptured cerebral aneurysm of the middle cerebral artery at 22,03%, ruptured cerebral aneurysm of the anterior communicating artery at 11,86%, and multiple cerebral aneurysms at 11,86%. The predominant imaging characteristics were Fisher IV at 52,9% and Fisher III at 25,7 %. The most frequent complications were vasospasm at 20,0 %, hydrocephalus at 12,9%, and electrolyte disturbances such as hypernatremia at 11,4% and hypokalemia at 11,4%. The mortality rate was 2,9%.