Primary Hemorrhagic Neurovascular Diseases in Tibetans: A Retrospective Observational Study

Abstract

Although there have been many studies on primary hemorrhagic neurovascular diseases (PHNVDs) in different populations, a study focusing on PHNVDs in Tibetan people was lacking. This study aimed to explore the notable characteristics of Tibetan PHNVDs by comparing the 3 most common PHNVDs (aneurysmal subarachnoid hemorrhage, spontaneous intracerebral hemorrhage, and arteriovenous malformation) in our institution between Tibetan and Han patients. In this retrospective observational study, the hospital information system was used to access the records of patients with PHNVDs. A total of 249 Tibetan patients and 2093 corresponding contemporary Han patients were recruited from January 2012 to January 2016. Sociodemographic information and clinical data on each PHNVD subtype were collected and compared between the 2 races. For Tibetan patients, a significantly higher incidence (P < 0.05) of rebleeding and cerebral infarction was observed in all 3 PHNVD subtypes. In the aneurysmal subarachnoid hemorrhage group, Tibetan patients had significantly higher incidence of blood blisterlike aneurysms (BLAs) (19.6% [19/97] vs. 3.2% [34/1071]; P < 0.001). In the spontaneous intracerebral hemorrhage group, Tibetan patients had a significantly higher incidence of brainstem hemorrhage in the subtentorial area (10.8% vs. 5.1%; P= 0.035). For Tibetan PHNVDs, a high incidence of BLAs in aneurysmal subarachnoid hemorrhage, a tendency toward brainstem hemorrhage in subtentorial spontaneous intracerebral hemorrhage, and a high rate of infarction and rebleeding in all 3 subtypes were all recognized.