Research Article
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Aneurysmal subarachnoid haemorrhage: A retrospective study of epidemiological, clinical and radiological findings

Year 2024, Volume: 41 Issue: 1, 177 - 184, 29.03.2024

Halit Şensoy Recai Engin Fatih Tomakin Durmuş Emre Karatoprak Bora Tetik

Abstract

In our study, we aimed to evaluate the data obtained by retrospective examination of the epidemiological, clinical, and radiological findings of the patients with aneurysmal subarachnoid hemorrhage. A group of 589 patients with spontaneous subarachnoid hemorrhage was evaluated retrospectively. The epidemiological, clinical, and radiological results of the patients were analyzed. It was found that the most common presentation to the emergency department with spontaneous subarachnoid hemorrhage was in the 6th decade, the female-to-male sex ratio was 1.5/1, the most common presentation time was winter-spring seasons, especially December, and the mortality rate was 39%. Headache was the most common presenting complaint. The epileptic seizure and loss of consciousness affected the prognosis negatively and increased mortality significantly. Hypertension was the most common chronic disease and was found to increase mortality. In FISHER and WFNS classifications, mortality increased as grade and class progressed. Spontaneous SAH and SA is a life-threatening pathology with high morbidity and mortality, difficult to treat and follow-up and significantly increasing healthcare costs.

Keywords

Spontaneous subarachnoid haemorrhage Cerebral aneurysm Epidemiology

Ethical Statement

Protection of human and animal subjects. The authors declare that no experiments were performed on humans or animals for this study. Confidentiality of data. The authors declare that they have followed the protocols of their work center on the publication of patient data. Right to privacy and informed consent. Right to privacy and informed consent. The authors have obtained approval from the Ethics Committee for analysis and publication of routinely acquired clinical data and informed consent was not required for this retrospective observational study. Use of artificial intelligence for generating text. The authors declare that they have not used any type of generative artificial intelligence for the writing of this manuscript, nor for the creation of images, graphics, tables, or their corresponding captions.

References

  • Marder CP, Narla V, Fink JR, & Tozer Fink KR. Subarachnoid hemorrhage: beyond aneurysms. American Journal of Roentgenology, 2014;202(1), 25-37
  • Al-Mistarehi AH, Elsayed MA, Ibrahim RM, Elzubair TH, Badi S, Ahmed MH, et al. Clinical outcomes of primary subarachnoid hemorrhage: an exploratory cohort study from Sudan. The Neurohospitalist, 2022;12(2),249-263
  • Kauvar DS, Lefering R, & Wade CE. Impact of hemorrhage on trauma outcome: an overview of epidemiology, clinical presentations, and therapeutic considerations. Journal of Trauma and Acute Care Surgery, 2006;60(6), S3-S11
  • Rossaint R, Bouillon B, Cerny V, Coats TJ, Duranteau J, Fernández-Mondéjar E et al. Management of haemorrhage following major trauma: an updated European guideline. Critical Care, 2010;14, 1-29.
  • Chou SHY, Feske SK, Atherton J, Konigsberg RG, De Jager PL, Du R et al. Early elevation of serum tumor necrosis factor-α is associated with poor outcome in subarachnoid hemorrhage. Journal of Investigative Medicine, 2012;60(7), 1054-1058.
  • Macdonald RL, & Schweizer TA. Spontaneous subarachnoid haemorrhage. The Lancet, 2017;389(10069), 655-666. van Lieshout JH, Dibué-Adjei M, Cornelius JF, Slotty PJ, Schneider T, Restin T et al. An introduction to the pathophysiology of aneurysmal subarachnoid hemorrhage. Neurosurgical Review, 2018;41,917-930.
  • Claassen J, & Park S. Spontaneous subarachnoid haemorrhage. The Lancet, 2022;400(10355), 846-862
  • Raatikainen, E. Delayed Cerebral Ischemia and Blood Coagulation Changes After Aneurysmal Subarachnoid Hemorrhage: Tampere University Dissertations, Tampere University, Faculty of Medicine and Health Technology Tampere University Hospital, Department of Intensive Care Medicine, Finland, 2023.
  • Andreasen, TH, Bartek Jr J, Andresen M, Springborg JB, & Romner B. Modifiable risk factors for aneurysmal subarachnoid hemorrhage. Stroke, 2013;44(12),3607-3612
  • Van Gijn J, Kerr RS, & Rinkel, GJ. Subarachnoid haemorrhage. The Lancet, 2007;369(9558), 306-318. de Oliveira Manoel AL, Goffi A, Zampieri FG, Turkel-Parrella D, Duggal A, Marotta TR, et al. The critical care management of spontaneous intracranial hemorrhage: a contemporary review. Critical Care, 2016;20,1-29
  • de Oliveira Manoel AL, Mansur A, Murphy A, Turkel-Parrella D, Macdonald M, Macdonald RL et al. Aneurysmal subarachnoid haemorrhage from a neuroimaging perspective. Critical Care, 2014;18(6),1-13
  • Shaban S, Huasen B, Haridas A, Killingsworth M, Worthington J, Jabbour P et al. Digital subtraction angiography in cerebrovascular disease: current practice and perspectives on diagnosis, acute treatment and prognosis. Acta Neurologica Belgica, 2021;1-18.
  • Molyneux A, Kerr R, Stratton I, Sandercock P, Clarke M, Shrimpton J et al. International Subarachnoid Aneurysm Trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised trial. Lancet, 2002;360(9342):1267–1274
  • Salary M, Quigley MR, Wilberger JE. Relation among aneurysm size, amount of subarachnoid blood, and clinical outcome. J Neurosurg, 2007;107(1):13–17
  • Wostrack M, Sandow N, Vajkoczy P, Schatlo B, Bijlenga P, Schaller K et al. Subarachnoid haemorrhage WFNS grade V: is maximal treatment worthwhile? Acta Neurochir, 2013;155(4):579–586
  • Teasdale G, Jennett B. Assessment of coma and impaired consciousness. A practical scale. Lancet, 1974;2(7872):81–84.
  • Clarke M. Systematic review of reviews of risk factors for intracranial aneurysms. Neuroradiology, 2008;50(8), 653-664
  • Ziemba-Davis M, Bohnstedt BN, Payner TD, Leipzig TJ, Palmer E, Cohen-Gadol AA. Incidence, Epidemiology, and Treatment of Aneurysmal Subarachnoid Hemorrhage in 12 Midwest Communities. J Stroke Cerebrovasc Dis, 2014;23(5):1073-82
  • Tong KA, Ashwal S, Holshouser BA, Shutter LA, Herigault G, Haacke EM et al. Hemorrhagic shearing lesions in children and adolescents with posttraumatic diffuse axonal injury: improved detection and initial results. Radiology, 2003;227(2):332-9
  • Devkota UP, Aryal KR. Result of surgery for ruptured intracranial aneurysms in Nepal. Br J Neurosurg, 2001;15: 13-6. Bozkuş H. Subarachnoid hemorrhage in the elderly. J Neurosurg, 1993;7: 307-9.
  • Chyette D, Chen TL, Bronstein K, Brass LM. Seasonal fluctution in the incidence of intracranial aneurysm rupture and its relationship to changing climatic conditions. J Neurosurg, 1984;81: 525-30.
  • Steiner T, Juvela S, Unterberg A, Jung C, Forsting M, Rinkel G. European Stroke Organization. European Stroke Organization guidelines for the management of intracranial aneurysms and subarachnoid haemorrhage. Cerebrovasc Dis, 2013;35:93-112.
  • Edlow JA, Malek AM, Ogilvy CS: Aneurysmal subarachnoid hemorrhage: update for emergency physicians. J Emerg Med, 2008;34: 237- 251
  • Kassell NF, Torner JC, Haley EC Jr, Jane JA, Adams HP, Kongable GL, et al. The international cooperative study on the timing of aneurysm surgery. Part I: Overall management results. J Neurosurg, 1990;73: 37-47
  • İlhan Y, Eseoğlu M, Demirgil B. Spontaneous Subarachnoid Hemorrhage Caused By Aneurysm: The Retrospective Analysis of 328 Cases, Fırat Tıp Dergisi, 2012;156-160
  • Gambhir S, O’Grady G, Koelmeyer T. Clinical lessons and risk factors from 403 fatal cases of subarachnoid haemorrhage. J Clin Neurosci. 2009;16: 921-4.
  • Jeong YG, Jung YT, Kim MS, Eun CK, Jang SH. Size and location of ruptured intracranial aneurysms. J Korean Neurosurg Soc. 2009;45: 11-5
  • van der Wee N, Rinkel GJ, Hasan D, van Gijn J. Detection of subarachnoid haemorrhage on early CT: Is lumbar puncture still needed after a negative scan? J Neurol Neurosurg Psychiatry, 1995;58: 357–359
  • Mayberg MR, Batjer HH, Dacey R, Diringer M, Haley EC, Heros RC et al. Guidelines for the management of aneurysmal subarachnoid hemorrhage. A statement for healthcare professionals from a special writing group of the Stroke Council, American Heart Association. Circulation, 1994;90(5), 2592-2605
  • Perry JJ, Stiell IG, Sivilotti ML, Bullard MJ, Hohl CM, Sutherland J, et al. Clinical decision rules to rule out subarachnoid hemorrhage for acute headache. JAMA, 2013;310(12), 1248-1255
  • Kowalski RG, Claassen J, Kreiter KT, Bates JE, Ostapkovich ND, Connolly ES, et al. Initial misdiagnosis and outcome after subarachnoid hemorrhage. Jama, 2004;291(7), 866-869.
  • McCarron MO, Alberts MJ, McCarron P. A systematic review of Terson’s syndrome; frequency and prognosis after subarachnoid haemorrhage. J Neurol Neurosurg Psychiatry, 2004;75:491-493
  • Leablanc R: The minor leek preceding subarachnoid hemorrhage. J Neurosurg, 1987;66: 35-9 Boling W, Kore L. Subarachnoid Hemorrhage-Related Epilepsy. In: Martin, R., Boling, W., Chen, G., Zhang, J. (eds)
  • Subarachnoid Hemorrhage. Acta Neurochirurgica Supplement, 2020;127. Springer, Cham. https://doi.org/10.1007/978-3-030-04615-6_4
  • Lantigua H, Ortega-Gutierrez S, Schmidt JM, Lee K, Badjatia N, Agarwal S, et al. Subarachnoid hemorrhage: who dies, and why?. Critical Care, 2015;19(1), 1-10
  • Bonilha L, Marques EL, Carelli EF, Fernandes YB, Cardoso AC, Maldaum MV, et al. Risk factors and outcome in 100 patients with aneurysmal subarachnoid hemorrhage. Arquivos de Neuro-Psiquiatria, 2001;59, 676-680
  • Drake CG, Hunt WE, Sano K. Report of World Federation of Neurosurgical Surgeons Committee on a Universal Subarachnoid Hemorrhage Grading Scale. J Neurosurg, 1988;68;985-986.
  • Kopitnik TA, Samson DS. Management of subarachnoid hemorrhage. J Neurol Neurosurg Psychiatry, 1993;56: 947-59.
  • Grasso G, Alafaci C, Macdonald RL. Management of aneurysmal subarachnoid hemorrhage: State of the art and future perspectives. Surg Neurol Int, 2017;8:1-10
  • Goldstein LB, Bushnell CD, Adams RJ, Chaturvedi S, Creager MA: Guidelines for the Primary Prevention of Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke, 2011;42: 517-84.
  • Lindbohm JV, Kaprio J, Korja M: Cholesterol as a risk factor for subarachoid hemorrhage: Systemic review. PLoS One,11:e0152568, 2016.
  • Zhang J, Liu G, Arima H, Li Y, Cheng G, Shiue I et al: Incidence and risks of subarachnoid hemorrhage in China. Stroke, 44:2891-2893, 2013
  • Piotin M, Spelle L, Mounayer C, Salles-Rezende MT, Giansante-Abud D, Vanzin-Santos R et al. Intracranial aneurysms: Treatment with bare platinum coils-aneurysm packing, complex coils, and angiographic recurrence. Radiology, 2007;243(2):500-508.
  • Yıldırım Ar A, Bayram T, and Turan G. The Effects of Grading Scales Used in Patients with Aneurysmal Subarachnoid Hemorrhage on Critical Care Outcomes. Kocaeli Medical Journal, 2020;9(1), 18-23.

Year 2024, Volume: 41 Issue: 1, 177 - 184, 29.03.2024

Halit Şensoy Recai Engin Fatih Tomakin Durmuş Emre Karatoprak Bora Tetik

Abstract

References

  • Marder CP, Narla V, Fink JR, & Tozer Fink KR. Subarachnoid hemorrhage: beyond aneurysms. American Journal of Roentgenology, 2014;202(1), 25-37
  • Al-Mistarehi AH, Elsayed MA, Ibrahim RM, Elzubair TH, Badi S, Ahmed MH, et al. Clinical outcomes of primary subarachnoid hemorrhage: an exploratory cohort study from Sudan. The Neurohospitalist, 2022;12(2),249-263
  • Kauvar DS, Lefering R, & Wade CE. Impact of hemorrhage on trauma outcome: an overview of epidemiology, clinical presentations, and therapeutic considerations. Journal of Trauma and Acute Care Surgery, 2006;60(6), S3-S11
  • Rossaint R, Bouillon B, Cerny V, Coats TJ, Duranteau J, Fernández-Mondéjar E et al. Management of haemorrhage following major trauma: an updated European guideline. Critical Care, 2010;14, 1-29.
  • Chou SHY, Feske SK, Atherton J, Konigsberg RG, De Jager PL, Du R et al. Early elevation of serum tumor necrosis factor-α is associated with poor outcome in subarachnoid hemorrhage. Journal of Investigative Medicine, 2012;60(7), 1054-1058.
  • Macdonald RL, & Schweizer TA. Spontaneous subarachnoid haemorrhage. The Lancet, 2017;389(10069), 655-666. van Lieshout JH, Dibué-Adjei M, Cornelius JF, Slotty PJ, Schneider T, Restin T et al. An introduction to the pathophysiology of aneurysmal subarachnoid hemorrhage. Neurosurgical Review, 2018;41,917-930.
  • Claassen J, & Park S. Spontaneous subarachnoid haemorrhage. The Lancet, 2022;400(10355), 846-862
  • Raatikainen, E. Delayed Cerebral Ischemia and Blood Coagulation Changes After Aneurysmal Subarachnoid Hemorrhage: Tampere University Dissertations, Tampere University, Faculty of Medicine and Health Technology Tampere University Hospital, Department of Intensive Care Medicine, Finland, 2023.
  • Andreasen, TH, Bartek Jr J, Andresen M, Springborg JB, & Romner B. Modifiable risk factors for aneurysmal subarachnoid hemorrhage. Stroke, 2013;44(12),3607-3612
  • Van Gijn J, Kerr RS, & Rinkel, GJ. Subarachnoid haemorrhage. The Lancet, 2007;369(9558), 306-318. de Oliveira Manoel AL, Goffi A, Zampieri FG, Turkel-Parrella D, Duggal A, Marotta TR, et al. The critical care management of spontaneous intracranial hemorrhage: a contemporary review. Critical Care, 2016;20,1-29
  • de Oliveira Manoel AL, Mansur A, Murphy A, Turkel-Parrella D, Macdonald M, Macdonald RL et al. Aneurysmal subarachnoid haemorrhage from a neuroimaging perspective. Critical Care, 2014;18(6),1-13
  • Shaban S, Huasen B, Haridas A, Killingsworth M, Worthington J, Jabbour P et al. Digital subtraction angiography in cerebrovascular disease: current practice and perspectives on diagnosis, acute treatment and prognosis. Acta Neurologica Belgica, 2021;1-18.
  • Molyneux A, Kerr R, Stratton I, Sandercock P, Clarke M, Shrimpton J et al. International Subarachnoid Aneurysm Trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised trial. Lancet, 2002;360(9342):1267–1274
  • Salary M, Quigley MR, Wilberger JE. Relation among aneurysm size, amount of subarachnoid blood, and clinical outcome. J Neurosurg, 2007;107(1):13–17
  • Wostrack M, Sandow N, Vajkoczy P, Schatlo B, Bijlenga P, Schaller K et al. Subarachnoid haemorrhage WFNS grade V: is maximal treatment worthwhile? Acta Neurochir, 2013;155(4):579–586
  • Teasdale G, Jennett B. Assessment of coma and impaired consciousness. A practical scale. Lancet, 1974;2(7872):81–84.
  • Clarke M. Systematic review of reviews of risk factors for intracranial aneurysms. Neuroradiology, 2008;50(8), 653-664
  • Ziemba-Davis M, Bohnstedt BN, Payner TD, Leipzig TJ, Palmer E, Cohen-Gadol AA. Incidence, Epidemiology, and Treatment of Aneurysmal Subarachnoid Hemorrhage in 12 Midwest Communities. J Stroke Cerebrovasc Dis, 2014;23(5):1073-82
  • Tong KA, Ashwal S, Holshouser BA, Shutter LA, Herigault G, Haacke EM et al. Hemorrhagic shearing lesions in children and adolescents with posttraumatic diffuse axonal injury: improved detection and initial results. Radiology, 2003;227(2):332-9
  • Devkota UP, Aryal KR. Result of surgery for ruptured intracranial aneurysms in Nepal. Br J Neurosurg, 2001;15: 13-6. Bozkuş H. Subarachnoid hemorrhage in the elderly. J Neurosurg, 1993;7: 307-9.
  • Chyette D, Chen TL, Bronstein K, Brass LM. Seasonal fluctution in the incidence of intracranial aneurysm rupture and its relationship to changing climatic conditions. J Neurosurg, 1984;81: 525-30.
  • Steiner T, Juvela S, Unterberg A, Jung C, Forsting M, Rinkel G. European Stroke Organization. European Stroke Organization guidelines for the management of intracranial aneurysms and subarachnoid haemorrhage. Cerebrovasc Dis, 2013;35:93-112.
  • Edlow JA, Malek AM, Ogilvy CS: Aneurysmal subarachnoid hemorrhage: update for emergency physicians. J Emerg Med, 2008;34: 237- 251
  • Kassell NF, Torner JC, Haley EC Jr, Jane JA, Adams HP, Kongable GL, et al. The international cooperative study on the timing of aneurysm surgery. Part I: Overall management results. J Neurosurg, 1990;73: 37-47
  • İlhan Y, Eseoğlu M, Demirgil B. Spontaneous Subarachnoid Hemorrhage Caused By Aneurysm: The Retrospective Analysis of 328 Cases, Fırat Tıp Dergisi, 2012;156-160
  • Gambhir S, O’Grady G, Koelmeyer T. Clinical lessons and risk factors from 403 fatal cases of subarachnoid haemorrhage. J Clin Neurosci. 2009;16: 921-4.
  • Jeong YG, Jung YT, Kim MS, Eun CK, Jang SH. Size and location of ruptured intracranial aneurysms. J Korean Neurosurg Soc. 2009;45: 11-5
  • van der Wee N, Rinkel GJ, Hasan D, van Gijn J. Detection of subarachnoid haemorrhage on early CT: Is lumbar puncture still needed after a negative scan? J Neurol Neurosurg Psychiatry, 1995;58: 357–359
  • Mayberg MR, Batjer HH, Dacey R, Diringer M, Haley EC, Heros RC et al. Guidelines for the management of aneurysmal subarachnoid hemorrhage. A statement for healthcare professionals from a special writing group of the Stroke Council, American Heart Association. Circulation, 1994;90(5), 2592-2605
  • Perry JJ, Stiell IG, Sivilotti ML, Bullard MJ, Hohl CM, Sutherland J, et al. Clinical decision rules to rule out subarachnoid hemorrhage for acute headache. JAMA, 2013;310(12), 1248-1255
  • Kowalski RG, Claassen J, Kreiter KT, Bates JE, Ostapkovich ND, Connolly ES, et al. Initial misdiagnosis and outcome after subarachnoid hemorrhage. Jama, 2004;291(7), 866-869.
  • McCarron MO, Alberts MJ, McCarron P. A systematic review of Terson’s syndrome; frequency and prognosis after subarachnoid haemorrhage. J Neurol Neurosurg Psychiatry, 2004;75:491-493
  • Leablanc R: The minor leek preceding subarachnoid hemorrhage. J Neurosurg, 1987;66: 35-9 Boling W, Kore L. Subarachnoid Hemorrhage-Related Epilepsy. In: Martin, R., Boling, W., Chen, G., Zhang, J. (eds)
  • Subarachnoid Hemorrhage. Acta Neurochirurgica Supplement, 2020;127. Springer, Cham. https://doi.org/10.1007/978-3-030-04615-6_4
  • Lantigua H, Ortega-Gutierrez S, Schmidt JM, Lee K, Badjatia N, Agarwal S, et al. Subarachnoid hemorrhage: who dies, and why?. Critical Care, 2015;19(1), 1-10
  • Bonilha L, Marques EL, Carelli EF, Fernandes YB, Cardoso AC, Maldaum MV, et al. Risk factors and outcome in 100 patients with aneurysmal subarachnoid hemorrhage. Arquivos de Neuro-Psiquiatria, 2001;59, 676-680
  • Drake CG, Hunt WE, Sano K. Report of World Federation of Neurosurgical Surgeons Committee on a Universal Subarachnoid Hemorrhage Grading Scale. J Neurosurg, 1988;68;985-986.
  • Kopitnik TA, Samson DS. Management of subarachnoid hemorrhage. J Neurol Neurosurg Psychiatry, 1993;56: 947-59.
  • Grasso G, Alafaci C, Macdonald RL. Management of aneurysmal subarachnoid hemorrhage: State of the art and future perspectives. Surg Neurol Int, 2017;8:1-10
  • Goldstein LB, Bushnell CD, Adams RJ, Chaturvedi S, Creager MA: Guidelines for the Primary Prevention of Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke, 2011;42: 517-84.
  • Lindbohm JV, Kaprio J, Korja M: Cholesterol as a risk factor for subarachoid hemorrhage: Systemic review. PLoS One,11:e0152568, 2016.
  • Zhang J, Liu G, Arima H, Li Y, Cheng G, Shiue I et al: Incidence and risks of subarachnoid hemorrhage in China. Stroke, 44:2891-2893, 2013
  • Piotin M, Spelle L, Mounayer C, Salles-Rezende MT, Giansante-Abud D, Vanzin-Santos R et al. Intracranial aneurysms: Treatment with bare platinum coils-aneurysm packing, complex coils, and angiographic recurrence. Radiology, 2007;243(2):500-508.
  • Yıldırım Ar A, Bayram T, and Turan G. The Effects of Grading Scales Used in Patients with Aneurysmal Subarachnoid Hemorrhage on Critical Care Outcomes. Kocaeli Medical Journal, 2020;9(1), 18-23.
There are 44 citations in total.

Details

Primary Language English
Subjects Brain and Nerve Surgery (Neurosurgery)
Journal Section Research Article
Authors

Halit Şensoy 0000-0002-8087-137X

Recai Engin 0000-0003-2957-9848

Fatih Tomakin 0000-0001-8290-2216

Durmuş Emre Karatoprak 0000-0001-8169-4208

Bora Tetik 0000-0001-7696-7785

Publication Date March 29, 2024
Submission Date February 8, 2024
Acceptance Date March 18, 2024
Published in Issue Year 2024 Volume: 41 Issue: 1

Cite

APA Şensoy, H., Engin, R., Tomakin, F., Karatoprak, D. E., et al. (2024). Aneurysmal subarachnoid haemorrhage: A retrospective study of epidemiological, clinical and radiological findings. Journal of Experimental and Clinical Medicine, 41(1), 177-184.
AMA Şensoy H, Engin R, Tomakin F, Karatoprak DE, Tetik B. Aneurysmal subarachnoid haemorrhage: A retrospective study of epidemiological, clinical and radiological findings. J. Exp. Clin. Med. March 2024;41(1):177-184.
Chicago Şensoy, Halit, Recai Engin, Fatih Tomakin, Durmuş Emre Karatoprak, and Bora Tetik. “Aneurysmal Subarachnoid Haemorrhage: A Retrospective Study of Epidemiological, Clinical and Radiological Findings”. Journal of Experimental and Clinical Medicine 41, no. 1 (March 2024): 177-84.
EndNote Şensoy H, Engin R, Tomakin F, Karatoprak DE, Tetik B (March 1, 2024) Aneurysmal subarachnoid haemorrhage: A retrospective study of epidemiological, clinical and radiological findings. Journal of Experimental and Clinical Medicine 41 1 177–184.
IEEE H. Şensoy, R. Engin, F. Tomakin, D. E. Karatoprak, and B. Tetik, “Aneurysmal subarachnoid haemorrhage: A retrospective study of epidemiological, clinical and radiological findings”, J. Exp. Clin. Med., vol. 41, no. 1, pp. 177–184, 2024.
ISNAD Şensoy, Halit et al. “Aneurysmal Subarachnoid Haemorrhage: A Retrospective Study of Epidemiological, Clinical and Radiological Findings”. Journal of Experimental and Clinical Medicine 41/1 (March 2024), 177-184.
JAMA Şensoy H, Engin R, Tomakin F, Karatoprak DE, Tetik B. Aneurysmal subarachnoid haemorrhage: A retrospective study of epidemiological, clinical and radiological findings. J. Exp. Clin. Med. 2024;41:177–184.
MLA Şensoy, Halit et al. “Aneurysmal Subarachnoid Haemorrhage: A Retrospective Study of Epidemiological, Clinical and Radiological Findings”. Journal of Experimental and Clinical Medicine, vol. 41, no. 1, 2024, pp. 177-84.
Vancouver Şensoy H, Engin R, Tomakin F, Karatoprak DE, Tetik B. Aneurysmal subarachnoid haemorrhage: A retrospective study of epidemiological, clinical and radiological findings. J. Exp. Clin. Med. 2024;41(1):177-84.
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