(Stroke. 1996;27:1793-1797.)
© 1996 American Heart Association, Inc.
Articles |
Circadian and Circannual Rhythmicity in the Occurrence of Subarachnoid Hemorrhage
the Emergency Department (M.G.) and the Departments of Anesthesiology (A.C.) and Neuroradiology (F.C.), St Anna Hospital, Ferrara, Italy, and the Departments of Internal Medicine (F.P., R.M.) and Neurosurgery (G.M., G.T.), University of Ferrara (Italy).
Correspondence to Massimo Gallerani, MD, Emergency Department, St Anna Hospital, corso Giovecca 203, I-44100 Ferrara, Italy.
Background and Purpose Inconsistent data are available on the temporal pattern of onset of subarachnoid hemorrhage (SAH). We investigated the possible influence of vascular risk factors.
Methods Of a consecutive series of 217 cases of SAH, precise determination (within 30 minutes) of the time of symptom onset was possible in 199 (91.7%). Partial Fourier series with up to six harmonics were applied to hourly and monthly data, and the best-fitting curves for circadian and annual rhythmicity were calculated. The amplitude-MESOR (rhythm-adjusted mean over the time period analyzed) ratio was used as a measure of temporal variability.
Results In the total population, a significant circadian pattern of occurrence was demonstrated with major peaks in the morning (
9 AM) and evening (9 PM) hours and a nocturnal trough (3 AM). Younger, male, and hypertensive subjects had lower amplitude-MESOR ratios; smokers had no significant rhythmicity. The annual pattern showed a 6-month periodicity with two major peaks in March and September and minor differences in the subgroups studied.
Conclusions Our study indicates that the temporal distribution in onset of SAH may be influenced by variable combinations of environmental and vascular risk factors.
Key Words: circadian rhythm • risk factors • stroke onset • subarachnoid hemorrhage
This article has been cited by other articles:
 |
|
 |
|
  R. Manfredini, D. Imberti, M. Gallerani, M. Verso, R. Pistelli, W. Ageno, and G. Agnelli Seasonal Variation in the Occurrence of Venous Thromboembolism: Data From the MASTER Registry Clinical and Applied Thrombosis/Hemostasis, June 1, 2009; 15(3): 309 - 315. [Abstract] [PDF]
|
|
|
|
 |
|
 J. B. Bederson, E. S. Connolly Jr, H. H. Batjer, R. G. Dacey, J. E. Dion, M. N. Diringer, J. E. Duldner Jr, R. E. Harbaugh, A. B. Patel, and R. H. Rosenwasser 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 Stroke, March 1, 2009; 40(3): 994 - 1025. [Full Text] [PDF]
|
|
|
|
 |
|
 S Omama, Y Yoshida, A Ogawa, T Onoda, and A Okayama Differences in circadian variation of cerebral infarction, intracerebral haemorrhage and subarachnoid haemorrhage by situation at onset J. Neurol. Neurosurg. Psychiatry, December 1, 2006; 77(12): 1345 - 1349. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. A. Wauschkuhn, K. Witte, S. Gorbey, B. Lemmer, and L. Schilling Circadian periodicity of cerebral blood flow revealed by laser-Doppler flowmetry in awake rats: relation to blood pressure and activity Am J Physiol Heart Circ Physiol, October 1, 2005; 289(4): H1662 - H1668. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. H. Mehta, R. Manfredini, F. Hassan, U. Sechtem, E. Bossone, J. K. Oh, J. V. Cooper, D. E. Smith, F. Portaluppi, M. Penn, et al. Chronobiological Patterns of Acute Aortic Dissection Circulation, August 27, 2002; 106(9): 1110 - 1115. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. Casetta, E. Granieri, F. Portaluppi, and R. Manfredini Circadian Variability in Hemorrhagic Stroke JAMA, March 13, 2002; 287(10): 1266 - 1267. [Full Text] [PDF]
|
|
|
|
 |
|
 I. Casetta, E. Granieri, E. Fallica, O. la Cecilia, E. Paolino, and R. Manfredini Patient Demographic and Clinical Features and Circadian Variation in Onset of Ischemic Stroke Arch Neurol, January 1, 2002; 59(1): 48 - 53. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. L. Feigin, C. S. Anderson, N. E. Anderson, J. B. Broad, M. J. Pledger, and R. Bonita Is There a Temporal Pattern in the Occurrence of Subarachnoid Hemorrhage in the Southern Hemisphere? : Pooled Data From 3 Large, Population-Based Incidence Studies in Australasia, 1981 to 1997 Stroke, March 1, 2001; 32(3): 613 - 619. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J R Fann, W A Kukull, W J Katon, and W T Longstreth Jr Physical activity and subarachnoid haemorrhage: a population based case-control study J. Neurol. Neurosurg. Psychiatry, December 1, 2000; 69(6): 768 - 772. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Manfredini, F. Portaluppi, R. Salmi, A. Martini, and M. Gallerani Circadian variation in onset of epistaxis: analysis of hospital admissions BMJ, November 4, 2000; 321(7269): 1112 - 1112. [Full Text]
|
|
|
|
 |
|
 L H Soo, D Gray, T Young, and J R Hampton Circadian variation in witnessed out of hospital cardiac arrest Heart, October 1, 2000; 84(4): 370 - 376. [Abstract] [Full Text]
|
|
|
|
|
|
S. Passero, F. Reale, G. Ciacci, and E. Zei Differing Temporal Patterns of Onset in Subgroups of Patients With Intracerebral Hemorrhage Stroke, July 1, 2000; 31(7): 1538 - 1544. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Ostbye, A. R. Levy, and N. E. Mayo Hospitalization and Case-Fatality Rates for Subarachnoid Hemorrhage in Canada From 1982 Through 1991 : The Canadian Collaborative Study Group of Stroke Hospitalizations Stroke, April 1, 1997; 28(4): 793 - 798. [Abstract] [Full Text]
|
|
|
|
|
|
S. E. Vermeer, G. J. E. Rinkel, and A. Algra Circadian Fluctuations in Onset of Subarachnoid Hemorrhage : New Data on Aneurysmal and Perimesencephalic Hemorrhage and a Systematic Review Stroke, April 1, 1997; 28(4): 805 - 808. [Abstract] [Full Text]
|
|