Subarachnoid hemorrhage

Prevention
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By Tania Rebeiz MD and James R Brorson MD

Smoking cessation, blood pressure control, and elimination of high-risk behaviors (cocaine and sympathomimetic use, heavy alcohol consumption) may help prevent aneurysm rupture (Connolly et al 2012). Education of physicians and the general public regarding signs and symptoms of subarachnoid hemorrhage might result in fewer misdiagnoses and earlier neurosurgical referral.

Familial clustering of aneurysms has been described, with studies demonstrating that first-degree relatives of patients with aneurysmal subarachnoid hemorrhage are between 2 and 5 times more likely to develop subarachnoid hemorrhage (Bor et al 2008). According to the American Heart Association/ American Stroke Association guidelines in 2012, noninvasive screening of patients with at least 1 first degree relative with aneurysmal subarachnoid hemorrhage and/or patients with previous aneurysmal subarachnoid hemorrhage may be reasonable, however more studies are needed to weigh the risks and benefits (Connolly et al 2012).

Education of physicians and the general public regarding signs and symptoms of subarachnoid hemorrhage might result in fewer misdiagnoses and earlier neurosurgical referral. This may reduce the high morbidity and mortality associated with a catastrophic subarachnoid hemorrhage.

In This Article

Introduction
Historical note and nomenclature
Clinical manifestations
Clinical vignette
Etiology
Pathogenesis and pathophysiology
Epidemiology
Prevention
Differential diagnosis
Diagnostic workup
Prognosis
Management
Outcomes
Pregnancy
Anesthesia
References cited
Contributors