J Cerebrovasc Endovasc Neurosurg.  2013 Sep;15(3):152-157. 10.7461/jcen.2013.15.3.152.

Association Between the Daily Temperature Range and Occurrence of Spontaneous Intracerebral Hemorrhage

• Jeong TS
• Park CW
• Yoo CJ
• Kim EY
• Kim YB
• Kim WK

• KMID: 1491432
• DOI: http://doi.org/10.7461/jcen.2013.15.3.152

Abstract

OBJECTIVE
We have observed, anecdotally, that the incidence of primary spontaneous intracerebral hemorrhage (sICH), as well as spontaneous subarachnoid hemorrhage, varies in accordance with seasonality and meteorological conditions. This retrospective single-hospital-based study aimed to determine the seasonality of sICH and the associations, if any, between the occurrence of sICH and meteorological parameters in Incheon city, which is a northwestern area of South Korea.
METHODS
Electronic hospital data on 708 consecutive patients admitted with primary sICH from January 2008 to December 2010 was reviewed. Traumatic and various secondary forms of ICHs were excluded. Average monthly admission numbers of sICH were analyzed, in relation with the local temperature, atmospheric pressure, humidity, and daily temperature range data. The relationships between the daily values of each parameter and daily admission numbers of sICH were investigated using a combination of correlation and time-series analyses.
RESULTS
No seasonal trend was observed in sICH-related admissions during the study period. Furthermore, no statistically significant correlation was detected between the daily sICH admission numbers and the meteorological parameters of temperature, atmospheric pressure and humidity. The daily temperature range tended to correlate with the number of daily sICH-related admissions (p = 0.097).
CONCLUSION
This study represents a comprehensive investigation of the association between various meteorological parameters and occurrence of spontaneous ICH. The results suggest that the daily temperature range may influence the risk of sICH.

Keyword

Meteorology; Seasonality; Spontaneous intracerebral hemorrhage; Weather

MeSH Terms

Atmospheric Pressure
Cerebral Hemorrhage
Electronics
Electrons
Humans
Humidity
Incidence
Meteorology
Retrospective Studies
Seasons
Subarachnoid Hemorrhage
Weather

Figure

• 

  Fig. 1 The relationship between the seasons and the monthly number of admissions due to spontaneous intracerebral hemorrhage (sICH). The association between the number of admission due to spontaneous intracerebral hemorhage and season was not statistically significant (F = 1.089, p = 0.368) (F: F distribution, p : p value). Analytical method: one-way analysis of variance between groups (ANOVA). Spring includes March, April and May; summer includes June, July and August; autumn includes September, October and November; and winter includes December, January and February.

• 

  Fig. 2 Monthly number of admissions due to primary sICH and seasonality of each meteorological parameter during the study period. Top panel indicates rates of sICH admissions from 2008 to 2011. The lower 4 panels show the expected seasonality in the standardized weather readings from 2008 to 2011.

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  Fig. 3 The number of monthly admissions due to primary sICH plotted against each meteorological factor. Mean temperature (r = 0.009, p = 0.959); mean humidity (r = -0.068, p = 0.695); mean atmospheric pressure (r = -0.017, p = 0.923); mean daily temperature range (r = 0.281, p = 0.097). sICH= spontaneous ICH.

Reference

1. Ali Y, Rahme R, Matar N, Ibrahim I, Menassa-Moussa L, Maarrawi J, et al. Impact of the lunar cycle on the incidence of intracranial aneurysm rupture: Myth or reality? Clin Neurol Neurosurg. 2008; 5. 110(5):462–465. PMID: 18353534.

2. Anderson CS, Chakera TM, Stewart-Wynne EG, Jamrozik KD. Spectrum of primary intracerebral haemorrhage in Perth, Western Australia, 1989-90: Incidence and outcome. J Neurol Neurosurg Psychiatry. 1994; 8. 57(8):936–940. PMID: 8057117.

3. Broderick JP, Brott T, Tomsick T, Miller R, Huster G. Intracerebral hemorrhage is more than twice as common as subarachnoid hemorrhage. J Neurosurg. 1993; 2. 78(2):188–191. PMID: 8421201.

4. Capon A, Demeurisse G, Zheng L. Seasonal variation of cerebral hemorrhage in 236 consecutive cases in Brussels. Stroke. 1992; 1. 23(1):24–27. PMID: 1731416.

5. Chambers JB, Williams TD, Nakamura A, Henderson RP, Overton JM, Rashotte ME. Cardiovascular and metabolic responses of hypertensive and normotensive rats to one week of cold exposure. Am J Physiol Regul Integr Comp Physiol. 2000; 10. 279(4):R1486–R1494. PMID: 11004019.

6. Cowperthwaite MC, Burnett MG. The association between weather and spontaneous subarachnoid hemorrhage: An analysis of 155 US hospitals. Neurosurgery. 2011; 1. 68(1):132–138. discussion 138-9. PMID: 21099710.

7. Feldmann E, Broderick JP, Kernan WN, Viscoli CM, Brass LM, Brott T, et al. Major risk factors for intracerebral hemorrhage in the young are modifiable. Stroke. 2005; 9. 36(9):1881–1885. PMID: 16081867.

8. Giaconi S, Ghione S, Palombo C, Genovesi-Ebert A, Marabotti C, Fommei E, et al. Seasonal influences on blood pressure in high normal to mild hypertensive range. Hypertension. 1989; 7. 14(1):22–27. PMID: 2737734.

9. Gill RS, Hambridge HL, Schneider EB, Hanff T, Tamargo RJ, Nyquist P. Falling temperature and colder weather are associated with an increased risk of aneurysmal subarachnoid hemorrhage. World Neurosurg. 2013; 1. 79(1):136–142. PMID: 22732514.

10. Haberman S, Capildeo R, Rose FC. The seasonal variation in mortality from cerebrovascualr disease. J Neurol Sci. 1981; 10. 52(1):25–36. PMID: 7299414.

11. Hughes MA, Grover PJ, Butler CR, Elwell VA, Mendoza ND. A 5-year retrospective study assessing the association between seasonal and meteorological change and incidence of aneurysmal subarachnoid haemorrhage. Br J Neurosurg. 2010; 8. 24(4):396–400. PMID: 20726749.

12. Inagawa T. Diurnal and seasonal variations in the onset of primary intracerebral hemorrhage in individuals living in Izumo City, Japan. J Neurosurg. 2003; 2. 98(2):326–336. PMID: 12593619.

13. Inagawa T, Takechi A, Yahara K, Saito J, Moritake K, Kobayashi S, et al. Primary intracerebral and aneurysmal subarachnoid hemorrhage in Izumo City, Japan. Part I: Incidence and seasonal and diurnal variations. J Neurosurg. 2000; 12. 93(6):958–966. PMID: 11117868.

14. Jabbour P, Tjoumakaris S, Dumont A, Gonzalez LF, Rosenwasser R. Aneurysm rupture: Lunar cycle, weather, atmospheric pressure, myth or reality? World Neurosurg. 2011; Jul-Aug. 76(1-2):7–8. PMID: 21839928.

15. Keatinge WR, Coleshaw SR, Cotter F, Mattock M, Murphy M, Chelliah R. Increases in platelet and red cell counts, blood viscosity, and arterial pressure during mild surface cooling: Factors in mortality from coronary and cerebral thrombosis in winter. Br Med J (Clin Res Ed). 1984; 11. 289(6456):1405–1408.

16. Kleinpeter G, Schatzer R, Bock F. Is blood pressure really a trigger for the circadian rhythm of subarachnoid hemorrhage? Stroke. 1995; 10. 26(10):1805–1810. PMID: 7570729.

17. Macdonald RL. Whether subarachnoid hemorrhage depends on the weather? World Neurosurg. 2013; 1. 79(1):64–65. PMID: 23103265.

18. Minami J, Kawano Y, Ishimitsu T, Yoshimi H, Takishita S. Seasonal variations in office, home and 24 h ambulatory blood pressure in patients with essential hypertension. J Hypertens. 1996; 12. 14(12):1421–1425. PMID: 8986924.

19. Shin MH, Park HK, Joo WI, Lee KJ, Rha HK. [Diurnal and Seasonal Variations in the Onset of Spontaneous Intracerebral Hemorrhage]. Korean J Cerebrovasc Surg. 2007; 3. 9(1):46–51. Korean.

20. Rønning P, Langmoen IA. Aneurysm rupture-does the weather matter? World Neurosurg. 2013; 1. 79(1):62–63. PMID: 22858847.

21. Special report from the National Institute of Neurological Disorders and Stroke. Classification of cerebrovascular diseases III. Stroke. 1990; 4. 21(4):637–676. PMID: 2326846.

22. Sobel E, Zhang ZX, Alter M, Lai SM, Davanipour Z, Friday G, et al. Stroke in the Lehigh valley: Seasonal variation in incidence rates. Stroke. 1987; Jan-Feb. 18(1):38–42. PMID: 3810768.

23. Takebayashi S. Ultrastructural morphometry of hypertensive medial damage in lenticulostriate and other arteries. Stroke. 1985; May-Jun. 16(3):449–453. PMID: 4002259.

24. Wang K, Li H, Liu W, You C. Seasonal variation in spontaneous intracerebral hemorrhage frequency in Chengdu, China, is independent of conventional risk factors. J Clin Neurosci. 2013; 4. 20(4):565–569. PMID: 23317754.

25. Woodhouse PR, Khaw KT, Plummer M. Seasonal variation of blood pressure and its relationship to ambient temperature in an elderly population. J Hypertens. 1993; 11. 11(11):1267–1274. PMID: 8301109.