National Estimates of Subarachnoid Hemorrhage Burden Need to Account for Within-Country Variations

Subarachnoid hemorrhage (SAH) from a ruptured intracranial aneurysm is a relatively rare (5%–9% of all strokes)1,2 but very devastating type of stroke, accounting for more than one-quarter of potential life-years lost through stroke.3 Despite robust evidence of significant (5- to 10-fold) between-country variations in SAH incidence rate and a global decline in incidence over the last 2 to 3 decades1,2 due largely to a decrease in blood pressure and smoking prevalence,1 evidence for within-country variations in SAH incidence and their possible determinants remains scarce. A large (9,443 first-ever SAH cases) nationwide Finnish study in all 5 regions of Finland of all hospitalized SAH cases and out-of-hospital fatal SAHs from 1998 to 2017 published in this issue of Neurology® aimed to fill this gap in the knowledge.4

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