title: A higher aneurysmal subarachnoid hemorrhage incidence in women prior to menopause: a retrospective analysis of 4,895 cases from eight hospitals in China.
abstract: 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.
authors.affiliation: 1 Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, Prince of Wales Hospital, New Territories, Hong Kong SAR, China ; 2 Department of Radiology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China ; 3 Department of Neurology, 4 Department of Neurosurgery, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, China ; 5 Department of Radiology, The Affiliated Hospital of Zunyi Medical University, Zunyi 563003, China ; 6 Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China ; 7 Department of Radiology, North Sichuan Medical College Hospital, Nanchong 637000, China ; 8 Department of Radiology, The First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an 710061, China ; 9 Department of Radiology, The General Hospital of Guangzhou Military Command, Guangzhou 510010, China ; 10 Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
authors.forename: Yì Xiáng J
authors.initials: YX
authors.lastname: Wáng
authors.affiliation: 1 Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, Prince of Wales Hospital, New Territories, Hong Kong SAR, China ; 2 Department of Radiology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China ; 3 Department of Neurology, 4 Department of Neurosurgery, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, China ; 5 Department of Radiology, The Affiliated Hospital of Zunyi Medical University, Zunyi 563003, China ; 6 Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China ; 7 Department of Radiology, North Sichuan Medical College Hospital, Nanchong 637000, China ; 8 Department of Radiology, The First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an 710061, China ; 9 Department of Radiology, The General Hospital of Guangzhou Military Command, Guangzhou 510010, China ; 10 Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
authors.forename: Jian
authors.initials: J
authors.lastname: He
authors.affiliation: 1 Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, Prince of Wales Hospital, New Territories, Hong Kong SAR, China ; 2 Department of Radiology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China ; 3 Department of Neurology, 4 Department of Neurosurgery, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, China ; 5 Department of Radiology, The Affiliated Hospital of Zunyi Medical University, Zunyi 563003, China ; 6 Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China ; 7 Department of Radiology, North Sichuan Medical College Hospital, Nanchong 637000, China ; 8 Department of Radiology, The First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an 710061, China ; 9 Department of Radiology, The General Hospital of Guangzhou Military Command, Guangzhou 510010, China ; 10 Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
authors.forename: Lihong
authors.initials: L
authors.lastname: Zhang
authors.affiliation: 1 Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, Prince of Wales Hospital, New Territories, Hong Kong SAR, China ; 2 Department of Radiology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China ; 3 Department of Neurology, 4 Department of Neurosurgery, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, China ; 5 Department of Radiology, The Affiliated Hospital of Zunyi Medical University, Zunyi 563003, China ; 6 Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China ; 7 Department of Radiology, North Sichuan Medical College Hospital, Nanchong 637000, China ; 8 Department of Radiology, The First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an 710061, China ; 9 Department of Radiology, The General Hospital of Guangzhou Military Command, Guangzhou 510010, China ; 10 Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
authors.forename: Yao
authors.initials: Y
authors.lastname: Li
authors.affiliation: 1 Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, Prince of Wales Hospital, New Territories, Hong Kong SAR, China ; 2 Department of Radiology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China ; 3 Department of Neurology, 4 Department of Neurosurgery, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, China ; 5 Department of Radiology, The Affiliated Hospital of Zunyi Medical University, Zunyi 563003, China ; 6 Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China ; 7 Department of Radiology, North Sichuan Medical College Hospital, Nanchong 637000, China ; 8 Department of Radiology, The First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an 710061, China ; 9 Department of Radiology, The General Hospital of Guangzhou Military Command, Guangzhou 510010, China ; 10 Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Zhao
authors.affiliation: 1 Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, Prince of Wales Hospital, New Territories, Hong Kong SAR, China ; 2 Department of Radiology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China ; 3 Department of Neurology, 4 Department of Neurosurgery, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, China ; 5 Department of Radiology, The Affiliated Hospital of Zunyi Medical University, Zunyi 563003, China ; 6 Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China ; 7 Department of Radiology, North Sichuan Medical College Hospital, Nanchong 637000, China ; 8 Department of Radiology, The First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an 710061, China ; 9 Department of Radiology, The General Hospital of Guangzhou Military Command, Guangzhou 510010, China ; 10 Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
authors.forename: Heng
authors.initials: H
authors.lastname: Liu
authors.affiliation: 1 Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, Prince of Wales Hospital, New Territories, Hong Kong SAR, China ; 2 Department of Radiology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China ; 3 Department of Neurology, 4 Department of Neurosurgery, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, China ; 5 Department of Radiology, The Affiliated Hospital of Zunyi Medical University, Zunyi 563003, China ; 6 Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China ; 7 Department of Radiology, North Sichuan Medical College Hospital, Nanchong 637000, China ; 8 Department of Radiology, The First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an 710061, China ; 9 Department of Radiology, The General Hospital of Guangzhou Military Command, Guangzhou 510010, China ; 10 Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Yang
authors.affiliation: 1 Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, Prince of Wales Hospital, New Territories, Hong Kong SAR, China ; 2 Department of Radiology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China ; 3 Department of Neurology, 4 Department of Neurosurgery, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, China ; 5 Department of Radiology, The Affiliated Hospital of Zunyi Medical University, Zunyi 563003, China ; 6 Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China ; 7 Department of Radiology, North Sichuan Medical College Hospital, Nanchong 637000, China ; 8 Department of Radiology, The First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an 710061, China ; 9 Department of Radiology, The General Hospital of Guangzhou Military Command, Guangzhou 510010, China ; 10 Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
authors.forename: Xian Jun
authors.initials: XJ
authors.lastname: Zeng
authors.affiliation: 1 Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, Prince of Wales Hospital, New Territories, Hong Kong SAR, China ; 2 Department of Radiology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China ; 3 Department of Neurology, 4 Department of Neurosurgery, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, China ; 5 Department of Radiology, The Affiliated Hospital of Zunyi Medical University, Zunyi 563003, China ; 6 Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China ; 7 Department of Radiology, North Sichuan Medical College Hospital, Nanchong 637000, China ; 8 Department of Radiology, The First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an 710061, China ; 9 Department of Radiology, The General Hospital of Guangzhou Military Command, Guangzhou 510010, China ; 10 Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Yang
authors.affiliation: 1 Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, Prince of Wales Hospital, New Territories, Hong Kong SAR, China ; 2 Department of Radiology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China ; 3 Department of Neurology, 4 Department of Neurosurgery, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, China ; 5 Department of Radiology, The Affiliated Hospital of Zunyi Medical University, Zunyi 563003, China ; 6 Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China ; 7 Department of Radiology, North Sichuan Medical College Hospital, Nanchong 637000, China ; 8 Department of Radiology, The First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an 710061, China ; 9 Department of Radiology, The General Hospital of Guangzhou Military Command, Guangzhou 510010, China ; 10 Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
authors.forename: Guang Ming
authors.initials: GM
authors.lastname: Peng
authors.affiliation: 1 Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, Prince of Wales Hospital, New Territories, Hong Kong SAR, China ; 2 Department of Radiology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China ; 3 Department of Neurology, 4 Department of Neurosurgery, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, China ; 5 Department of Radiology, The Affiliated Hospital of Zunyi Medical University, Zunyi 563003, China ; 6 Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China ; 7 Department of Radiology, North Sichuan Medical College Hospital, Nanchong 637000, China ; 8 Department of Radiology, The First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an 710061, China ; 9 Department of Radiology, The General Hospital of Guangzhou Military Command, Guangzhou 510010, China ; 10 Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
authors.forename: Anil
authors.initials: A
authors.lastname: Ahuja
authors.affiliation: 1 Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, Prince of Wales Hospital, New Territories, Hong Kong SAR, China ; 2 Department of Radiology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China ; 3 Department of Neurology, 4 Department of Neurosurgery, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, China ; 5 Department of Radiology, The Affiliated Hospital of Zunyi Medical University, Zunyi 563003, China ; 6 Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China ; 7 Department of Radiology, North Sichuan Medical College Hospital, Nanchong 637000, China ; 8 Department of Radiology, The First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an 710061, China ; 9 Department of Radiology, The General Hospital of Guangzhou Military Command, Guangzhou 510010, China ; 10 Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
authors.forename: Zheng Han
authors.initials: ZH
authors.lastname: Yang
keywords: Physiological gender difference; aneurysmal subarachnoid hemorrhage; cerebral aneurysm; epidemiology