Blood blister-like aneurysms in Tibetans: A retrospective observational study

- This is so far the first and largest study about the Blood blister-like aneurysms in Tibetan populations. Several interesting characters about Tibetan BLAs were observed:
- A high risk of occurrence and atypical locations.
- A high incidence of cerebral infarction.
- A poor prognosis in neurological functional recovery at 90 days follow-up.
- Endovascular treatment benefits more in reducing cerebral infarctions and improving neurological functional recovery prognosis.

ObjectAlthough 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.MethodsIn 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.ResultsCompared 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.ConclusionsCompared 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.