{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T17:36:41Z","timestamp":1778780201917,"version":"3.51.4"},"reference-count":48,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2014,12]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>The pathophysiology of aneurysmal subarachnoid hemorrhage (aSAH) is unclear. Sex may play a role in the outcome of patients with aSAH.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>The authors retrospectively identified 617 patients with aSAH (April 2005 to February 2010) and analyzed sex differences in risk factors (age, hypertension, smoking, alcohol consumption, and family history), admission-related factors (World Federation of Neurosurgical Societies grade and admission delay), aneurysm characteristics (site, side, location, and multiplicity), and outcomes (treatment modalities [coiling\/clipping\/both\/conservative], complications [vasospasm and hydrocephalus], length of stay, and modified Rankin Scale score at 3 months).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>The female patients with aSAH were older than the male patients (mean age 56.6 vs 51.9 years, respectively, p &lt; 0.001), and more women than men were \u2265 55 years old (56.2% vs 40.4%, respectively, p &lt; 0.001). Women exhibited higher rates of bilateral (6.8% vs 2.6%, respectively, p &lt; 0.05), multiple (11.5% vs 5.2%, respectively, p &lt; 0.05), and internal carotid artery (ICA) (36.9% vs 17.5%, respectively, p &lt; 0.001) aneurysms and a lower rate of anterior cerebral artery aneurysms (26.3% vs 44.8%, respectively, p &lt; 0.001) than the men, but no side differences were noted. There were no sex differences in risk factors, admission-related factors, or outcome measures. For both sexes, outcomes varied according to aneurysm location, with odds ratios for a poor outcome of 1.62 (95% CI 0.91\u20132.86, p = 0.1) for middle cerebral artery, 2.41 (95% CI 1.29\u20134.51, p = 0.01) for ICA, and 2.41 (95% CI 1.29\u20134.51, p = 0.006) for posterior circulation aneurysms compared with those for anterior cerebral artery aneurysms. The odds ratio for poor outcome (modified Rankin Scale score of 4\u20136) in women compared with men after adjusting for significant prognostic factors was 0.71 (95% CI 0.45\u20131.11, p &gt; 0.05).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The overall outcomes after aSAH between women and men are similar.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2014.7.jns132318","type":"journal-article","created":{"date-parts":[[2014,9,18]],"date-time":"2014-09-18T17:54:58Z","timestamp":1411062898000},"page":"1367-1373","source":"Crossref","is-referenced-by-count":77,"title":["Subarachnoid hemorrhage and the female sex: analysis of risk factors, aneurysm characteristics, and outcomes"],"prefix":"10.3171","volume":"121","author":[{"given":"Alhafidz","family":"Hamdan","sequence":"first","affiliation":[{"name":"Faculty of Medical Sciences, Newcastle University;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Barnes","sequence":"additional","affiliation":[{"name":"Faculty of Medical Sciences, Newcastle University;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Royal Victoria Infirmary, Newcastle Upon Tyne, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-jns132318","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"1569","DOI":"10.1007\/s00701-009-0316-3","article-title":"Differences in anatomical distribution, gender, and sidedness between ruptured and unruptured intracranial aneurysms in a defined patient population","volume":"151","author":"Aarhus","year":"2009"},{"key":"b2-jns132318","series-title":"Ann Neurol","doi-asserted-by":"publisher","first-page":"929","DOI":"10.1002\/ana.410380614","article-title":"Familial subarachnoid hemorrhage: distinctive features and patterns of inheritance","volume":"38","author":"Bromberg","year":"1995"},{"key":"b3-jns132318","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"856","DOI":"10.3171\/jns.2005.102.5.0856","article-title":"Sex differences in outcome following sports-related concussion","volume":"102","author":"Broshek","year":"2005"},{"key":"b4-jns132318","series-title":"Eur J Radiol","doi-asserted-by":"publisher","first-page":"1598","DOI":"10.1016\/j.ejrad.2012.12.026","article-title":"Epidemiology and genetics of intracranial aneurysms","volume":"82","author":"Caranci","year":"2013"},{"key":"b5-jns132318","series-title":"Ann Biomed Eng","doi-asserted-by":"publisher","first-page":"1366","DOI":"10.1007\/s10439-012-0723-0","article-title":"Suggested connections between risk factors of intracranial aneurysms: a review","volume":"41","author":"Cebral","year":"2013"},{"key":"b6-jns132318","series-title":"J Neurol Neurosurg Psychiatry","doi-asserted-by":"publisher","first-page":"1365","DOI":"10.1136\/jnnp.2007.117655","article-title":"Incidence of subarachnoid haemorrhage: a systematic review with emphasis on region, age, gender and time trends","volume":"78","author":"de Rooij","year":"2007"},{"key":"b7-jns132318","series-title":"J Neurointerv Surg","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1136\/neurintsurg-2012-010364","article-title":"Younger age of menopause in women with cerebral aneurysms","volume":"5","author":"Ding","year":"2013"},{"key":"b8-jns132318","series-title":"Circ Cardiovasc Imaging","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1161\/CIRCIMAGING.111.965467","article-title":"Sex differences in myocardial salvage and clinical outcome in patients with acute reperfused ST-elevation myocardial infarction: advances in cardiovascular imaging","volume":"5","author":"Eitel","year":"2012"},{"key":"b9-jns132318","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"728","DOI":"10.3171\/jns.2001.94.5.0728","article-title":"Risk factors for the formation of multiple intracranial aneurysms","volume":"94","author":"Ellamushi","year":"2001"},{"key":"b10-jns132318","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"388","DOI":"10.3171\/jns.1996.85.3.0388","article-title":"Predicting length of hospital stay and cost by aneurysm grade on admission","volume":"85","author":"Elliott","year":"1996"},{"issue":"1","key":"b11-jns132318","series-title":"Neurosurg Focus","first-page":"E6","article-title":"Do women fare worse? 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