title: Blood blister-like aneurysms in Tibetans: A retrospective observational study.
abstract: OBJECTIVE
  Although research on blood blister-like aneurysms (BLAs) in different population is well documented, studies of that in the plateau area remain elusive. This study aimed to develop a better understanding of BLAs in Tibetan population, which is a typical representation of people in plateau area.
  
  
  METHODS
  In this retrospective observational study, the hospital information system (HIS) was used to search for consecutive patients with BLAs by using the discharge diagnoses. A total of 19 Tibetan patients and 34 Han patients were recruited from January 2012 to January 2016. Intra-hospital and follow-up data were collected and compared between two races.
  
  
  RESULTS
  Compared with Han group, Tibetan group got significantly higher ratio of BLAs among aneurysmal subarachnoid hemorrhages (aSAHs) (19.6% (19/97) vs 3.2% (34/1071), p<0.001), higher Incidence of atypical located BLAs (26.3% vs 2.9%, p=0.034), higher risk of cerebral infarction (63.2% vs 11.8%, p<0.001), and greater number of patients with unfavorable outcomes at 6 months after ictus (57.9% vs 23.5%, p=0.028). In Tibetan group, patients underwent endovascular treatment presented with significantly lower cerebral infarction rate (p=0.019) and better neurological functional recovery outcome (p=0.048) compared with surgical group.
  
  
  CONCLUSIONS
  Compared with Han patients, Tibetan BLA patients presented with high risk of occurrence with atypical locations and high incidence of cerebral infarctions with poor prognoses. Endovascular treatment benefits more for Tibetan BLA patients in reducing cerebral infarctions and improving neurological functional recovery prognosis.
authors.affiliation: Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
authors.forename: Ruiqi
authors.initials: R
authors.lastname: Chen
authors.affiliation: Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
authors.forename: Anqi
authors.initials: A
authors.lastname: Xiao
authors.affiliation: Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
authors.forename: Lu
authors.initials: L
authors.lastname: Ma
authors.affiliation: Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
authors.forename: Sen
authors.initials: S
authors.lastname: Lin
authors.affiliation: Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China. Electronic address: huaxi_youchao@163.com.
authors.forename: Chao
authors.initials: C
authors.lastname: You
mesh_terms: D000328:Adult; D000368:Aged; D017542:Aneurysm, Ruptured; D044466:Asian People; D001768:Blister / Q000453:epidemiology / Q000601:surgery; D002544:Cerebral Infarction / Q000453:epidemiology / Q000209:etiology; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D015994:Incidence; D002532:Intracranial Aneurysm / Q000453:epidemiology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012189:Retrospective Studies; D013345:Subarachnoid Hemorrhage / Q000453:epidemiology / Q000601:surgery; D016019:Survival Analysis; D018609:Tibet / Q000453:epidemiology; D016896:Treatment Outcome
keywords: Blood blister-like aneurysms; Cerebral aneurysm; Endovascular treatment; Han; Surgical treatment; Tibetan