Abstract
Subarachnoid haemorrhage represents 8% of all cerebrovascular events. Up to 25% of patients are dead within 24 hours, the figure rising to perhaps 50% by three months [1]. Subarachnoid haemorrhage from aneurysmal rupture reaches a peak incidence in the early fifties, some 20 years later than for cases due to arteriovenous malformation [2]. Anterior communicating aneurysms are the commonest source of subarachnoid bleeding, followed by posterior communicating then middle cerebral aneurysms. Vertebrobasilar aneurysms account for some 5% of the total [2]. Aneurysmal rupture is more common in women, except for the anterior communicating group. Some 20% of patients have more than one aneurysm. Other sources of subarachnoid haemorrhage include primary haemorrhage into the brain substance with subsequent rupture into the subarachnoid space or ventricular system, and bleeding due to a disorder of haemostasis.
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References
Adams, H.P. Jr, Kassell, N.F., Torner, J.C. and Sahs, A.L. (1983) CT and clinical correlations in recent aneurysmal subarachnoid hemorrhage: A preliminary report of the cooperative aneurysm study. Neurology, 33, 981–8.
Locksley, H.B. (1966) Natural history of subarachnoid hemorrhage, intracranial aneurysms and arteriovenous malformations. Based on 6368 cases in the cooperative study. J. Neurosurg., 25, 219–39.
Winn, H.R., Richardson, A.E. and Jane, J.A. (1977) The long-term prognosis in untreated cerebral aneurysms. 1. A 10-year evaluation of 364 patients. Ann. Neurol., 1, 358–70.
Stober, T. and Kunze, K. (1982) Electrocardiographic alterations in subarachnoid haemorrhage. Correlation between spasm of the arteries of the left side of the brain and T inversion and QT prolongation. J. Neurol., 227, 99–113.
Margerison, J.H., Binne, C.D. and McCaul, I.R. (1970) Electroencephalographic signs employed in the location of ruptured intracranial arterial aneurysms. Electroencephalogr. Clin. Neurophysiol., 28, 296–306.
Géraud, G., Tremoulet, M., Guell, A. and Bes, A. (1984) The prognostic value of noninvasive CBF measurement in subarachnoid hemorrhage. Stroke, 15, 301–5.
Adams, H.P. Jr, Jergenson, D.D., Kassell, N.F. and Sahs, A.L. (1980) Pitfalls in the recognition of subarachnoid hemorrhage. J. Am. Med. Assoc., 244, 794–6.
Tourtellotte, W.W., Metz, L.N., Bryan, E.R. and De Jong, R.N. (1964) Spontaneous subarachnoid hemorrhage. Factors affecting the rate of clearing of the cerebrospinal fluid. Neurology, 14, 301–6.
Richardson, J.C. and Hyland, H.H. (1941) Intracranial aneurysms. A clinical and pathological study of subarachnoid and intracerebral haemorrhage caused by berry aneurysms. Medicine (Baltimore), 20, 1–83.
Roost, K.T., Pimstone, N.R., Diamond, I. and Schmid, R. (1972) The formation of cerebrospinal fluid xanthochromia after subarachnoid hemorrhage. Enzymatic conversion of hemoglobin to bilirubin by the arachnoid and choroid plexus. Neurology, 22, 973–7.
Petito, F. and Plum, F. (1974) The lumbar puncture. N. Engl. J. Med., 290, 225–7.
Vincent, F.M. (1981) Hypoglycorrhachia after subarachnoid hemorrhage. Neurosurgery, 8, 7–9.
Duffy, G.P. (1982) Lumbar puncture in spontaneous subarachnoid haemorrhage. Br. Med. J., 285, 1163–4.
Davis, J.M., Davis, K.R. and Crowell, R.M. (1980) Subarachnoid hemorrhage secondary to ruptured intracranial aneurysm: prognostic significance of cranial CT. Am. J. Roentgenol., 134, 711–15.
Gurusinghe, N.T. and Richardson, A.E. (1984) The value of computerized tomography in aneurysmal subarachnoid hemorrhage. The concept of the CT score. J. Neurosurg., 60, 763–70.
Doczi, T., Ambrose, J. and O’Laoire, S. (1984) Significance of contrast enhancement in cranial computerized tomography after subarachnoid hemorrhage. J. Neurosurg., 60, 335–42.
Weisberg, L.A. (1985) Ruptured aneurysms of anterior cerebral or anterior communicating arteries: CT patterns. Neurology, 35, 1562–6.
Van Gijn, J. and Van Dongen, K.J. (1980) Computerized tomography in subarachnoid hemorrhage: difference between patients with and without an aneurysm on angiography. Neurology, 30, 538–9.
Perrett, L.V. and Bull, J.W.D. (1959) Some aspects of subarachnoid haemorrhage — a symposium III. The accuracy of radiology in demonstrating ruptured intracranial aneurysms. Br. J. Radiol., 32, 85–92.
Forster, D.M.C., Steiner, L., Hakanson, S. and Bergvall, U. (1978) The value of repeat pan-angiography in cases of unexplained subarachnoid hemorrhage. J. Neurosurg., 48, 712–16.
Gautier, J.C. (1985) Stroke-in-evolution. Stroke, 16, 729–33.
Come, P.C., Riley, M.F. and Bivas, N.K. (1983) Roles of echocardiography and arrhythmia monitoring in the evaluation of patients with suspected systemic embolism. Ann. Neurol., 13, 527–31.
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© 1988 G.D. Perkin
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Perkin, G.D. (1988). Neurological emergencies — 2. In: Diagnostic Tests in Neurology. Diagnostic Tests Series. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-3320-1_12
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DOI: https://doi.org/10.1007/978-1-4899-3320-1_12
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