Materiały źródłowe

• #1 Subarachnoid hemorrhage (SAH)

  https://mayfieldclinic.com/pe-sah.htm

  Subarachnoid hemorrhage (SAH) is a life-threatening type of stroke caused by bleeding into the space surrounding the brain. SAH can be caused by a ruptured aneurysm, AVM, or head injury. […] The most common causes of SAH include: Aneurysm: a balloon-like bulge or weakening of an artery wall that ruptures, releasing blood into the subarachnoid space around the brain. […] Arteriovenous malformation (AVM): an abnormal tangle of arteries and veins with no capillaries in between. The weakened blood vessels can rupture and bleed. […] Traumatic brain injury: during the impact of an accident, the brain crashes back and forth inside the skull tearing blood vessels. […] Five to 10% of strokes are caused by SAH.

• #2 Hemorrhagic Stroke | American Stroke Association

  https://www.stroke.org/en/about-stroke/types-of-stroke/hemorrhagic-strokes-bleeds

  Hemorrhagic strokes make up about 13% of stroke cases. They occur when a weakened vessel ruptures and bleeds into the surrounding brain. The two types of hemorrhagic strokes are intracerebral hemorrhage (within the brain) or subarachnoid hemorrhage (between the inner and outer layers of the tissue covering the brain. […] A brain AVM contains abnormal “weakened” blood vessels that direct blood away from normal brain tissue. These abnormal and weak blood vessels dilate over time. Eventually, they may burst from the high pressure of blood flow from the arteries. […] If an aneurysm ruptures, it may leak blood into the space around the brain. This is called a subarachnoid hemorrhage. Depending on the amount of blood, it can produce sudden severe headache that can last from several hours to days. […] Subarachnoid hemorrhage and intracerebral hemorrhage are two types of hemorrhagic stroke. The bleeding damages the brain and can lead to weakness or paralysis of an arm or leg, trouble speaking or understanding language, vision problems, seizures, and death.

• #3 Subarachnoid hemorrhage – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/subarachnoid-hemorrhage/symptoms-causes/syc-20361009

  A subarachnoid hemorrhage may be caused by: […] A brain aneurysm that bursts. A brain aneurysm is a bulge in a blood vessel in the brain. The aneurysm can burst and cause bleeding in the space between the brain and the tissues covering the brain, known as the subarachnoid space. A brain aneurysm is the most common cause of a subarachnoid hemorrhage. […] Another common cause is a head injury. A head injury from an auto accident, fall or violence can lead to a subarachnoid hemorrhage. […] A tangle of blood vessels in the brain, known as an arteriovenous malformation. This irregular tangle of blood vessels can rupture and cause bleeding in the brain. […] Swelling of the blood vessels, known as vasculitis. This can cause the walls of the blood vessels to thicken and narrow. Vasculitis can lead to a blood clot or an aneurysm.

• #4 Subarachnoid Hemorrhage – UF Health

  https://ufhealth.org/conditions-and-treatments/subarachnoid-hemorrhage

  Subarachnoid hemorrhage can be caused by any of several factors: […] A head injury. This is the most common cause of an intracranial hemorrhage in people younger than 50. […] Arteriovenous malformation. This is an anatomical abnormality in the arteries or veins in or around the brain. […] An aneurysm. This is a weakness in the wall of an artery causing a pouch or a swelling in the blood vessel. […] An infection […] Atherosclerosis.

• #5 Traumatic subarachnoid hemorrhage | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/traumatic-subarachnoid-haemorrhage-1?lang=us

  Traumatic subarachnoid hemorrhage is a common injury, and trauma is the most common cause of subarachnoid hemorrhage (SAH). […] The exact mechanism of tSAH remains uncertain although it is clear that a number of etiologies exist and these will determine, at least to a degree, the distribution of blood. Causes of tSAH include direct extravasation of blood from an adjacent cerebral contusion, arterial dissection, direct damage to small veins or arteries, and sudden increase in intravascular pressures leading to rupture.

• #6 Subarachnoid hemorrhage: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000701.htm

  Subarachnoid hemorrhage can be caused by: […] Bleeding from a tangle of blood vessels called an arteriovenous malformation (AVM) […] Bleeding disorder […] Bleeding from a cerebral aneurysm (weak area in the wall of a blood vessel that causes the blood vessel to bulge or balloon out) […] Head injury […] Unknown cause (idiopathic) […] Use of blood thinners. […] Subarachnoid hemorrhage caused by head injury in older people is often due to falls. Among the young, the most common injury leading to subarachnoid hemorrhage is motor vehicle crashes. […] Risks include: […] Unruptured aneurysm in the brain and other blood vessels […] Fibromuscular dysplasia (FMD) and other connective tissue and autoimmune disorders […] High blood pressure […] History of polycystic kidney disease […] Smoking […] Use of illicit drugs such as cocaine and methamphetamine […] Use of blood thinners such as warfarin. […] A strong family history of aneurysms may also increase your risk.

• #7 Subarachnoid hemorrhage | Causes, Symptoms & Treatment | Britannica

  https://www.britannica.com/science/subarachnoid-hemorrhage

  subarachnoid hemorrhage, bleeding into the space between the two innermost protective coverings surrounding the brain, the pia mater and the arachnoid mater. A subarachnoid hemorrhage most often occurs as the result of significant head trauma and is usually seen in the setting of skull fractures or injuries to the brain itself. […] Some authorities prefer to classify traumatic subarachnoid hemorrhages as a separate disorder from those that occur spontaneously as the result of a ruptured aneurysm or other internal pathology. […] A subarachnoid hemorrhage is typically symptomatic, with headache and an alteration of consciousness being common. […] The subarachnoid space is prone to blood collection whenever there is damage to any of the cerebral blood vessels that travel beneath the arachnoid layer, in close proximity to the surface of the brain. Subarachnoid hemorrhages often occur spontaneously. In these cases, approximately 85% of the hemorrhages are the result of a ruptured cerebral aneurysm. Other causes of spontaneous subarachnoid hemorrhage include arteriovenous malformations, anticoagulation therapy, and the use of certain illicit drugs such as cocaine.

• #8 Traumatic subarachnoid hemorrhage | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/traumatic-subarachnoid-haemorrhage-1?lang=us

  Traumatic subarachnoid hemorrhage is a common injury, and trauma is the most common cause of subarachnoid hemorrhage (SAH). […] The exact mechanism of tSAH remains uncertain although it is clear that a number of etiologies exist and these will determine, at least to a degree, the distribution of blood. Causes of tSAH include direct extravasation of blood from an adjacent cerebral contusion, arterial dissection, direct damage to small veins or arteries, and sudden increase in intravascular pressures leading to rupture.

• #9 Subarachnoid Hemorrhage – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441958/

  Subarachnoid hemorrhages are life-threatening and result from the accumulation of blood between the arachnoid and pia mater. […] The etiology of SAH can be either nontraumatic (about 85% are secondary to aneurysm rupture) or traumatic in nature. […] Most nontraumatic causes of SAH (~ 85%) are caused by the rupture of an intracranial aneurysm. […] As elucidated earlier, about 85% of nontraumatic SAH cases are secondary to aneurysmal rupture. […] The most common causes of nontraumatic SAH are mentioned below: […] An aneurysmal cause of SAH has similar risk factors associated with aneurysm formation. Hypertension, cigarette smoking, and family history are the most consistently observed risk factors. […] Older age (60 years), posterior circulation location, atherosclerosis, hypertension, and large Intra-arterial aneurysm (IA) size (5 mm) are contributing factors for an IA to rupture. […] Cocaine abuse is associated with aneurysmal and nonaneurysmal SAH. […] Cerebral amyloid angiopathy can cause SAH in older adults. […] Cerebral venous thrombosis, sickle cell disorders, moyamoya disease, cerebral vasculitis, and bleeding disorders are some of the conditions that cause SAH.

• #10 Subarachnoid haemorrhage: diagnosis, causes and management – PubMed

  https://pubmed.ncbi.nlm.nih.gov/11157554/

  The cause of SAH is a ruptured aneurysm in 85% of cases, non-aneurysmal perimesencephalic haemorrhage (with excellent prognosis) in 10%, and a variety of rare conditions in 5%. […] A poor clinical condition on admission may be caused by a remediable complication of the initial bleed or a recurrent haemorrhage in the form of intracranial haematoma, acute hydrocephalus or global brain ischaemia.

• #11 Subarachnoid hemorrhage – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/subarachnoid-hemorrhage/symptoms-causes/syc-20361009

  A subarachnoid hemorrhage may be caused by: […] A brain aneurysm that bursts. A brain aneurysm is a bulge in a blood vessel in the brain. The aneurysm can burst and cause bleeding in the space between the brain and the tissues covering the brain, known as the subarachnoid space. A brain aneurysm is the most common cause of a subarachnoid hemorrhage. […] Another common cause is a head injury. A head injury from an auto accident, fall or violence can lead to a subarachnoid hemorrhage. […] A tangle of blood vessels in the brain, known as an arteriovenous malformation. This irregular tangle of blood vessels can rupture and cause bleeding in the brain. […] Swelling of the blood vessels, known as vasculitis. This can cause the walls of the blood vessels to thicken and narrow. Vasculitis can lead to a blood clot or an aneurysm.

• #12 Subarachnoid Haemorrhage: Causes, Symptoms, Treatment

  https://patient.info/doctor/subarachnoid-haemorrhage-pro

  Berry aneurysms are common with a prevalence of approximately 4%. […] It is not clearly understood why some adults develop saccular aneurysms at arterial bifurcations in the Circle of Willis but most do not. There may be variation in the susceptibility of the elastic lamina of the arterial wall to the known stressors of hypertension and smoking.

• #13 Subarachnoid Hemorrhage – Harvard Health

  https://www.health.harvard.edu/a_to_z/subarachnoid-hemorrhage-a-to-z

  Most often, a subarachnoid hemorrhage happens because a bulge in the wall of an artery ruptures. The sac-like bulge is called a saccular aneurysm. A subarachnoid hemorrhage also can occur because blood leaks from an abnormal tangle of blood vessels called an arteriovenous malformation (AVM). […] Although it is not possible to predict whether an aneurysm will rupture, an aneurysm is more likely to rupture when it has a diameter of 7 millimeters or more. […] AVMs can appear in several generations of the same family and are more common in men. Bleeding from an AVM most often occurs between the ages of 10 and 30. […] It is almost impossible to prevent subarachnoid hemorrhage caused by an aneurysm or AVM. These blood vessel abnormalities usually do not cause any symptoms before the hemorrhage occurs. Smoking has been shown to increase the risk of forming an aneurysm, so avoiding smoking may prevent some cases of hemorrhagic stroke. […] Without treatment of an aneurysm or AVM that bled, the risk of rebleeding is significant. Successful treatment greatly lowers this risk.

• #14 Diagnosis and management of subarachnoid haemorrhage | Nature Communications

  https://www.nature.com/articles/s41467-024-46015-2

  Subarachnoid haemorrhage (SAH), a neurovascular emergency with an incidence in the UK, is approximately 8 per 100,000 population, peaking at 50-60 years and is 1.6 times more common in women than men. The spontaneous rupture of an intracranial aneurysm (80-85%) is the most common cause of SAH. […] History of familial aneurysms (at least one first-degree relative with an intracranial aneurysm) and certain genetic diseases such as autosomal dominant polycystic kidney disease, Ehlers-Danlos syndrome type IV, Marfan syndrome, and neurofibromatosis type 1 have been identified as predisposing factors to cerebral aneurysms. […] The factors associated with an increased risk of rupture of a cerebral aneurysm are hypertension, smoking, cocaine and alcohol usage. The risk of rupture also varies according to the size (7mm) and location, with anterior and posterior aneurysms at a higher risk of rupture than middle cerebral artery (MCA) aneurysms.

• #15 Subarachnoid Hemorrhage: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/1164341-overview

  Of nontraumatic subarachnoid hemorrhages, approximately 80% are due to a ruptured berry aneurysm. […] Rupture of arteriovenous malformations (AVMs) is the second most identifiable cause of SAH, accounting for 10% of cases of SAH. […] Most of the remaining cases result from rupture of the following types of pathologic entities: mycotic aneurysm, angioma, neoplasm, cortical thrombosis. […] SAH may reflect a secondary dissection of blood from an intraparenchymal hematoma (eg, bleeding from hypertension or neoplasm). […] Both congenital and acquired factors are thought to play a role in SAH. […] Evidence supporting the role of congenital causes in aneurysm formation includes clusters of familial occurrence, such as in Finland, where the incidence of familial cerebral aneurysm is 10%.

• #16 Subarachnoid hemorrhage – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/subarachnoid-hemorrhage/symptoms-causes/syc-20361009

  A subarachnoid hemorrhage may be caused by: […] A brain aneurysm that bursts. A brain aneurysm is a bulge in a blood vessel in the brain. The aneurysm can burst and cause bleeding in the space between the brain and the tissues covering the brain, known as the subarachnoid space. A brain aneurysm is the most common cause of a subarachnoid hemorrhage. […] Another common cause is a head injury. A head injury from an auto accident, fall or violence can lead to a subarachnoid hemorrhage. […] A tangle of blood vessels in the brain, known as an arteriovenous malformation. This irregular tangle of blood vessels can rupture and cause bleeding in the brain. […] Swelling of the blood vessels, known as vasculitis. This can cause the walls of the blood vessels to thicken and narrow. Vasculitis can lead to a blood clot or an aneurysm.

• #17 Isolated Acute Nontraumatic Cortical Subarachnoid Hemorrhage | American Journal of Neuroradiology

  http://www.ajnr.org/content/31/8/1355

  SUMMARY: Our aim was to review the etiologic background of isolated acute nontraumatic cSAH. While SAH located in the basal cisterns originates from a ruptured aneurysm in approximately 85% of cases, a broad spectrum of vascular and even nonvascular pathologies can cause acute nontraumatic SAH along the convexity. […] Nontraumatic (spontaneous) SAH arises in approximately 85% of cases from rupture of a saccular aneurysm at the base of the brain. Nonaneurysmal perimesencephalic hemorrhages account for another 10%. […] Spontaneous acute cSAH observed at the convexity of the brain is a relatively rare entity, seldom described, with various vascular and nonvascular causes, including the following: CVT (both dural and cortical), vascular malformations (pial arteriovenous malformations, dural arteriovenous fistulas, and cavernomas), RCVS, vasculitides, infectious aneurysms, Moyamoya disease or syndrome, severe atherosclerotic carotid disease, PRES, CAA, and nonvascular disorders, such as primary and secondary brain neoplasms or even abscess.

• #18 Pediatric Subarachnoid Hemorrhage: Rare Events with Important Implications | Auctores

  https://www.auctoresonline.org/article/pediatric-subarachnoid-hemorrhage-rare-events-with-important-implications

  Rupture of an aneurysm is the leading cause of subarachnoid hemorrhage (SAH) which results in accumulation of blood between the arachnoid and pia mater, consequently increasing intracranial pressure. […] Aneurysms, arteriovenous malformations, and pediatric tumors are the most common causes of pSAH. Increased predilection is based on genetics or underlying infection. […] Common causes of pSAH include genetic and infectious etiologies that predispose children to develop aneurysms. […] Genetic and infectious predispositions include: Alagille syndrome, sickle cell anemia, irradiation, cardiac myxoma (Carney complex), HIV/AIDS, tuberous sclerosis, vascular anomalies, Marfan syndrome, syphilis, Moya Moya disease, pseudoxanthoma elasticum, type IV Ehlers-Danlos syndrome, fibromuscular dysplasia, von Hippel-Lindau syndrome, arterio-venous malformations secondary to Osler-Weber-Rendu Syndrome, hypertension, coarctation of the aorta and polycystic kidney disease.

• #19 Subarachnoid Hemorrhage: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/1164341-overview

  Significant incidence of multiple aneurysms in patients with SAH (15%). […] The association of aneurysms with specific congenital diseases (eg, coarctation of the aorta, Marfan syndrome, Ehlers-Danlos syndrome, fibromuscular dysplasia, polycystic kidney disease). […] Acquired factors thought to be associated with aneurysmal formation include atherosclerosis, hypertension, advancing age, smoking, hemodynamic stress. […] Less common causes of SAH include fusiform and mycotic aneurysms, fibromuscular dysplasia, blood dyscrasias, moyamoya disease, infection, neoplasm, trauma (fracture at the base of the skull leading to internal carotid aneurysm), amyloid angiopathy (especially in elderly people), vasculitis. […] Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by recurrent thunderclap headaches and reversible segmental multifocal cerebral artery narrowing, and it results in SAH in more than 30% of cases.

• #20 Spontaneous Non-Aneurysmal Convexity Subarachnoid Hemorrhage: A Scoping Review of Different Etiologies beyond Cerebral Amyloid Angiopathy

  https://www.mdpi.com/2077-0383/13/15/4382

  Spontaneous convexity subarachnoid hemorrhage (cSAH) is a vascular disease different from aneurysmal SAH in neuroimaging pattern, causes, and prognosis. Several causes might be considered in individual patients, with a limited value of the patient’s age for discriminating among these causes. Cerebral amyloid angiopathy (CAA) is the most prevalent cause in people > 60 years, but reversible cerebral vasoconstriction syndrome (RCVS) has to be considered in young people. […] cSAH might have different underlying causes, and age is important to select the most probable causes. In younger people, the most probable causes include reversible cerebral vasoconstriction syndrome (RCVS) with or without posterior reversible encephalopathy syndrome (PRES), cerebral venous thrombosis (CVT), and others rarer diseases. In people > 60 years, cerebral amyloid angiopathy (CAA) is the most common cause.

• #21 Spontaneous Non-Aneurysmal Convexity Subarachnoid Hemorrhage: A Scoping Review of Different Etiologies beyond Cerebral Amyloid Angiopathy

  https://www.mdpi.com/2077-0383/13/15/4382

  CAA is one of the main causes of spontaneous cSAH, and the Boston 2.0 criteria added cSAH as a hemorrhagic manifestation of the disease suitable for diagnosis. […] The prognosis for CAA-related cortical subarachnoid hemorrhage (cSAH) has been detailed in a recent study, revealing the following risks per patient-year: intracerebral hemorrhage (ICH) at 13.2%, recurrent cSAH at 11.1%, combined ICH or cSAH at 21.4%, ischemic stroke at 5.1%, and mortality at 8.3%. […] Extracranial or intracranial artery stenosis, including internal carotid artery (ICA) or middle cerebral artery (MCA) stenosis, is rarely documented in cases of cSAH. […] cSAH is a rare finding in infective endocarditis (IE), occurring in about 5% of cases. […] CVT has long been recognized as a cause of parenchymal hemorrhage. cSAH, either isolated or in combination with parenchymal hemorrhages, represents a rare manifestation of CVT, accounting for 6.5% of patients in the largest series.

• #22 Aneurysmal subarachnoid hemorrhage: Epidemiology, risk factors, and pathogenesis – UpToDate

  https://www.uptodate.com/contents/aneurysmal-subarachnoid-hemorrhage-epidemiology-risk-factors-and-pathogenesis

  Aneurysmal subarachnoid hemorrhage: Epidemiology, risk factors, and pathogenesis […] Most spontaneous SAHs are caused by ruptured saccular aneurysms. Other causes include occult trauma, arteriovenous malformations/fistulae, vasculitides, intracranial arterial dissections, amyloid angiopathy, bleeding diatheses, and illicit drug use (especially cocaine and amphetamines). […] The epidemiology and risk factors of aneurysmal SAH are reviewed here.

• #23 Convexity subarachnoid haemorrhage: a practical guide | Practical Neurology

  https://pn.bmj.com/content/23/5/368

  Atraumatic convexity subarachnoid haemorrhage describes spontaneous bleeding into the convexities of the brain sulci without parenchymal involvement. Its many causes include reversible cerebral vasoconstriction syndrome, cerebral sinus venous thrombosis, posterior reversible encephalopathy syndrome and (in older people) cerebral amyloid angiopathy. […] The causes of cSAH in younger people include reversible cerebral vasoconstriction syndrome (RCVS), posterior reversible encephalopathy syndrome (PRES), cerebral sinus venous thrombosis and others. In people aged over 60 years, cerebral amyloid angiopathy (CAA) is a common cause. […] CAA probably results from an imbalance between the production and clearance of A, a breakdown product of A precursor protein. Excessive A accumulates in the small leptomeningeal and cortical blood vessels, which become brittle and fragile, allowing blood leakage into the subarachnoid space. […] The recurrent nature of CAA-related transient focal neurological episodes is probably due to cortical spreading depolarisation.

• #24 Subarachnoid hemorrhage: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000701.htm

  Subarachnoid hemorrhage can be caused by: […] Bleeding from a tangle of blood vessels called an arteriovenous malformation (AVM) […] Bleeding disorder […] Bleeding from a cerebral aneurysm (weak area in the wall of a blood vessel that causes the blood vessel to bulge or balloon out) […] Head injury […] Unknown cause (idiopathic) […] Use of blood thinners. […] Subarachnoid hemorrhage caused by head injury in older people is often due to falls. Among the young, the most common injury leading to subarachnoid hemorrhage is motor vehicle crashes. […] Risks include: […] Unruptured aneurysm in the brain and other blood vessels […] Fibromuscular dysplasia (FMD) and other connective tissue and autoimmune disorders […] High blood pressure […] History of polycystic kidney disease […] Smoking […] Use of illicit drugs such as cocaine and methamphetamine […] Use of blood thinners such as warfarin. […] A strong family history of aneurysms may also increase your risk.

• #25 Subarachnoid hemorrhage – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/subarachnoid-hemorrhage/symptoms-causes/syc-20361009

  A subarachnoid hemorrhage may be caused by: […] A brain aneurysm that bursts. A brain aneurysm is a bulge in a blood vessel in the brain. The aneurysm can burst and cause bleeding in the space between the brain and the tissues covering the brain, known as the subarachnoid space. A brain aneurysm is the most common cause of a subarachnoid hemorrhage. […] Another common cause is a head injury. A head injury from an auto accident, fall or violence can lead to a subarachnoid hemorrhage. […] A tangle of blood vessels in the brain, known as an arteriovenous malformation. This irregular tangle of blood vessels can rupture and cause bleeding in the brain. […] Swelling of the blood vessels, known as vasculitis. This can cause the walls of the blood vessels to thicken and narrow. Vasculitis can lead to a blood clot or an aneurysm.

• #26 Spontaneous Non-Aneurysmal Convexity Subarachnoid Hemorrhage: A Scoping Review of Different Etiologies beyond Cerebral Amyloid Angiopathy

  https://www.mdpi.com/2077-0383/13/15/4382

  Primary angiitis of the central nervous system (PACNS) is a rare cerebrovascular disease characterized by transmural inflammation of leptomeningeal, cerebral, and spinal vessels. […] Posterior reversible encephalopathy syndrome (PRES) is a clinical and neuroradiological condition associating different neurological manifestations with a typical brain vasogenic edema. […] Vascular malformations (dural artero-venous fistulae or DAVF and artero-venous malformations or AVM) are only very rarely the cause of isolated cSAH without concomitant aneurysms.

• #27 Isolated Acute Nontraumatic Cortical Subarachnoid Hemorrhage | American Journal of Neuroradiology

  http://www.ajnr.org/content/31/8/1355

  Cortical SAH may be seen after rupture of infectious aneurysms (caused by infective endocarditis, meningitis, or rarely cryptogenically). […] Most intracranial hemorrhages in Moyamoya occur within the brain parenchyma or the ventricles. SAH is unusual and may result from the rupture of associated saccular aneurysms with basal topography. […] CAA is seldom described as a cause of symptomatic or occult SAH but is increasingly recognized as a cause of superficial hemosiderosis. […] The exact origin of cSAH in CAA remains unknown, but rupture of leptomeningeal arteries weakened by amyloid deposits seems a plausible hypothesis.

• #28 Pediatric Subarachnoid Hemorrhage: Rare Events with Important Implications | Auctores

  https://www.auctoresonline.org/article/pediatric-subarachnoid-hemorrhage-rare-events-with-important-implications

  Rupture of an aneurysm is the leading cause of subarachnoid hemorrhage (SAH) which results in accumulation of blood between the arachnoid and pia mater, consequently increasing intracranial pressure. […] Aneurysms, arteriovenous malformations, and pediatric tumors are the most common causes of pSAH. Increased predilection is based on genetics or underlying infection. […] Common causes of pSAH include genetic and infectious etiologies that predispose children to develop aneurysms. […] Genetic and infectious predispositions include: Alagille syndrome, sickle cell anemia, irradiation, cardiac myxoma (Carney complex), HIV/AIDS, tuberous sclerosis, vascular anomalies, Marfan syndrome, syphilis, Moya Moya disease, pseudoxanthoma elasticum, type IV Ehlers-Danlos syndrome, fibromuscular dysplasia, von Hippel-Lindau syndrome, arterio-venous malformations secondary to Osler-Weber-Rendu Syndrome, hypertension, coarctation of the aorta and polycystic kidney disease.

• #29 Subarachnoid Hemorrhage (SAH): Symptoms and Treatment | Ada

  https://ada.com/conditions/subarachnoid-hemorrhage/

  Risk factors that lead to SAH less commonly include: Head and neck trauma, when bleeding from injury to the brain or other nearby structures leaks into the subarachnoid space, which is known as traumatic subarachnoid hemorrhage; Certain inherited conditions that weaken the blood vessels, such as autosomal dominant polycystic kidney disease (ADPKD), Marfan-Syndrome, and Ehlers-Danlos syndrome; Vasculitis, when blood vessels inside the body, and therefore possibly also inside the brain become swollen and inflamed due to infection or to conditions affecting the immune system; Brain infection such as encephalitis or meningitis.

• #30 Brain Hemorrhage: Symptoms & Causes | NewYork-Presbyterian

  https://www.nyp.org/neuro/brain-hemorrhage

  Blood or bleeding disorders – People who have diseases such as hemophilia and sickle cell anemia are more likely to experience brain bleeds. Their conditions contribute to lower levels of blood platelets and clotting. Additionally, patients on blood thinners have an increased risk of brain bleeds […] Liver disease – People with liver conditions have an increased risk of bleeding issues […] Brain tumors – Those who have had brain tumors are at a higher risk of developing a brain hemorrhage.

• #31 Isolated Acute Nontraumatic Cortical Subarachnoid Hemorrhage | American Journal of Neuroradiology

  http://www.ajnr.org/content/31/8/1355

  SUMMARY: Our aim was to review the etiologic background of isolated acute nontraumatic cSAH. While SAH located in the basal cisterns originates from a ruptured aneurysm in approximately 85% of cases, a broad spectrum of vascular and even nonvascular pathologies can cause acute nontraumatic SAH along the convexity. […] Nontraumatic (spontaneous) SAH arises in approximately 85% of cases from rupture of a saccular aneurysm at the base of the brain. Nonaneurysmal perimesencephalic hemorrhages account for another 10%. […] Spontaneous acute cSAH observed at the convexity of the brain is a relatively rare entity, seldom described, with various vascular and nonvascular causes, including the following: CVT (both dural and cortical), vascular malformations (pial arteriovenous malformations, dural arteriovenous fistulas, and cavernomas), RCVS, vasculitides, infectious aneurysms, Moyamoya disease or syndrome, severe atherosclerotic carotid disease, PRES, CAA, and nonvascular disorders, such as primary and secondary brain neoplasms or even abscess.

• #32 Spontaneous Non-Aneurysmal Convexity Subarachnoid Hemorrhage: A Scoping Review of Different Etiologies beyond Cerebral Amyloid Angiopathy

  https://www.mdpi.com/2077-0383/13/15/4382

  Primary angiitis of the central nervous system (PACNS) is a rare cerebrovascular disease characterized by transmural inflammation of leptomeningeal, cerebral, and spinal vessels. […] Posterior reversible encephalopathy syndrome (PRES) is a clinical and neuroradiological condition associating different neurological manifestations with a typical brain vasogenic edema. […] Vascular malformations (dural artero-venous fistulae or DAVF and artero-venous malformations or AVM) are only very rarely the cause of isolated cSAH without concomitant aneurysms.

• #33 Subarachnoid hemorrhage: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000701.htm

  Subarachnoid hemorrhage can be caused by: […] Bleeding from a tangle of blood vessels called an arteriovenous malformation (AVM) […] Bleeding disorder […] Bleeding from a cerebral aneurysm (weak area in the wall of a blood vessel that causes the blood vessel to bulge or balloon out) […] Head injury […] Unknown cause (idiopathic) […] Use of blood thinners. […] Subarachnoid hemorrhage caused by head injury in older people is often due to falls. Among the young, the most common injury leading to subarachnoid hemorrhage is motor vehicle crashes. […] Risks include: […] Unruptured aneurysm in the brain and other blood vessels […] Fibromuscular dysplasia (FMD) and other connective tissue and autoimmune disorders […] High blood pressure […] History of polycystic kidney disease […] Smoking […] Use of illicit drugs such as cocaine and methamphetamine […] Use of blood thinners such as warfarin. […] A strong family history of aneurysms may also increase your risk.

• #34 Isolated Acute Nontraumatic Cortical Subarachnoid Hemorrhage | American Journal of Neuroradiology

  http://www.ajnr.org/content/31/8/1355

  SUMMARY: Our aim was to review the etiologic background of isolated acute nontraumatic cSAH. While SAH located in the basal cisterns originates from a ruptured aneurysm in approximately 85% of cases, a broad spectrum of vascular and even nonvascular pathologies can cause acute nontraumatic SAH along the convexity. […] Nontraumatic (spontaneous) SAH arises in approximately 85% of cases from rupture of a saccular aneurysm at the base of the brain. Nonaneurysmal perimesencephalic hemorrhages account for another 10%. […] Spontaneous acute cSAH observed at the convexity of the brain is a relatively rare entity, seldom described, with various vascular and nonvascular causes, including the following: CVT (both dural and cortical), vascular malformations (pial arteriovenous malformations, dural arteriovenous fistulas, and cavernomas), RCVS, vasculitides, infectious aneurysms, Moyamoya disease or syndrome, severe atherosclerotic carotid disease, PRES, CAA, and nonvascular disorders, such as primary and secondary brain neoplasms or even abscess.

• #35 Subarachnoid hemorrhage – Wikipedia

  https://en.wikipedia.org/wiki/Subarachnoid_hemorrhage

  Bleeding into the brain’s subarachnoid space […] SAH may occur as a result of a head injury or spontaneously, usually from a ruptured cerebral aneurysm. […] In 85 percent of spontaneous cases the cause is a cerebral aneurysm, a weakness in the wall of one of the arteries in the brain that becomes enlarged. […] Cocaine abuse and sickle cell anemia (usually in children) and, rarely, anticoagulant therapy, problems with blood clotting and pituitary apoplexy can also result in SAH. […] Most cases of SAH are due to trauma such as a blow to the head. […] Traumatic SAH usually occurs near the site of a skull fracture or intracerebral contusion. […] In 15-20 percent of cases of spontaneous SAH, no aneurysm is detected on the first angiogram. […] The remainder are due to other disorders affecting the blood vessels (such as cerebral arteriovenous malformations), disorders of the blood vessels in the spinal cord, and bleeding into various tumors.

• #36 The Radiology Assistant : Non-traumatic Intracranial Hemorrhage

  https://radiologyassistant.nl/neuroradiology/hemorrhage/non-traumatic-intracranial-hemorrhage

  Subarachnoid hemorrhage (SAH) is bleeding in the subarachnoid space between the arachnoid and the pia mater. […] The most common cause is trauma. […] Non-traumatic SAH is usually the result of aneurysmal rupture with spread of blood into the subarchnoidal cisterns. […] The major risk factor is increasing age. […] Hypertensive intracranial haemorrhage together with CAA make up 80% of the causes of intraparenchymal hematomas. […] Non-traumatic SAH is the result of aneurysmal rupture with spread of blood into the subarachnoid cisterns. […] The location of the aneurysm can be suspected from the location of the hemorrhage. […] Perimesencephalic subarachnoid hemorrhage is a nonaneurysmal form of SAH. […] The causes of PMSAH suggest a venous or capillary rupture at the level of the tentorial hiatus. […] The differential diagnosis of high signal in the subarachnoid space on MRI is large. […] If the CTA does not show an aneurysm and the clinical and CT-findings are compatible with a perimesenphalic hemorrhage, no further investigation is necessary.

• #37 Subarachnoid Haemorrhage: Causes, Symptoms, Treatment

  https://patient.info/doctor/subarachnoid-haemorrhage-pro

  Approximately 85% of patients bleed from intracranial arterial aneurysms, 10% from a non-aneurysmal peri-mesencephalic haemorrhage and 5% from other vascular abnormalities including arteriovenous malformation, vasculitis and abnormal blood vessels associated with tumour. […] Risk factors for spontaneous SAH are the same as for stroke in general, particularly smoking, excessive alcohol consumption, and hypertension. Genetic factors account for only a very small proportion of cases. […] The bigger the aneurysm, the more likely it is to bleed. However, as about 90% of aneurysms are small, the majority that bleed are less than 1 cm in diameter. […] Hypertension – the global SAH incidence declined with every millimetre of mercury decrease in systolic blood pressure by 7.1%. […] Excessive alcohol intake roughly doubles the risk – its role has not been as well established as that of smoking, but drinking more than 37.5 units a week accounts for up to 1 in 5 cases of subarachnoid haemorrhage.

• #38 Subarachnoid Hemorrhage and Hemorrhagic Stroke | Supreme Vascular and Interventional Clinic

  https://supremevascular.com/conditions-and-treaments/stroke-and-stroke-screening/subarachnoid-hemorrhage-and-hemorrhagic-stroke/

  Hypertension, or high blood pressure, is another risk factor. The condition puts stress on blood vessels and weakens their walls. As a result, a rupture is a likely outcome. […] Classically, subarachnoid stroke happens more commonly in the young age group of patients and is a known cause of sudden death in younger individuals.

• #39 Subarachnoid Hemorrhage – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441958/

  Subarachnoid hemorrhages are life-threatening and result from the accumulation of blood between the arachnoid and pia mater. […] The etiology of SAH can be either nontraumatic (about 85% are secondary to aneurysm rupture) or traumatic in nature. […] Most nontraumatic causes of SAH (~ 85%) are caused by the rupture of an intracranial aneurysm. […] As elucidated earlier, about 85% of nontraumatic SAH cases are secondary to aneurysmal rupture. […] The most common causes of nontraumatic SAH are mentioned below: […] An aneurysmal cause of SAH has similar risk factors associated with aneurysm formation. Hypertension, cigarette smoking, and family history are the most consistently observed risk factors. […] Older age (60 years), posterior circulation location, atherosclerosis, hypertension, and large Intra-arterial aneurysm (IA) size (5 mm) are contributing factors for an IA to rupture. […] Cocaine abuse is associated with aneurysmal and nonaneurysmal SAH. […] Cerebral amyloid angiopathy can cause SAH in older adults. […] Cerebral venous thrombosis, sickle cell disorders, moyamoya disease, cerebral vasculitis, and bleeding disorders are some of the conditions that cause SAH.

• #40 Content – Health Encyclopedia – University of Rochester Medical Center

  https://www.urmc.rochester.edu/encyclopedia/content?contenttypeid=134&contentid=68

  A subarachnoid hemorrhage may cause a type of stroke called a hemorrhagic stroke. […] Most subarachnoid hemorrhages are caused by bleeding after a brain aneurysm rupture. […] A brain aneurysm can lead to a subarachnoid hemorrhage. […] Part of the long-term treatment of a subarachnoid hemorrhage includes addressing any risk factors that may have helped trigger the hemorrhage. […] One of the biggest risk factors is smoking. […] A subarachnoid hemorrhage can also irritate and damage the brain’s other blood vessels, causing them to tighten. […] This reduces blood flow to the brain.

• #41 Subarachnoid Haemorrhage: Causes, Symptoms, Treatment

  https://patient.info/doctor/subarachnoid-haemorrhage-pro

  Approximately 85% of patients bleed from intracranial arterial aneurysms, 10% from a non-aneurysmal peri-mesencephalic haemorrhage and 5% from other vascular abnormalities including arteriovenous malformation, vasculitis and abnormal blood vessels associated with tumour. […] Risk factors for spontaneous SAH are the same as for stroke in general, particularly smoking, excessive alcohol consumption, and hypertension. Genetic factors account for only a very small proportion of cases. […] The bigger the aneurysm, the more likely it is to bleed. However, as about 90% of aneurysms are small, the majority that bleed are less than 1 cm in diameter. […] Hypertension – the global SAH incidence declined with every millimetre of mercury decrease in systolic blood pressure by 7.1%. […] Excessive alcohol intake roughly doubles the risk – its role has not been as well established as that of smoking, but drinking more than 37.5 units a week accounts for up to 1 in 5 cases of subarachnoid haemorrhage.

• #42 Subarachnoid Hemorrhage – Symptoms, Diagnosis, TreatmentGroup 9Group 9Group 49Group 49

  https://www.barrowneuro.org/condition/subarachnoid-hemorrhage/

  A subarachnoid hemorrhage (SAH) is a type of hemorrhagic stroke caused by bleeding into the subarachnoid space, which is the area between the brain and the thin tissues, called meninges, that cover it. […] The most common cause of a subarachnoid hemorrhage (SAH) is the rupture of a cerebral aneurysm—a weak spot in the wall of a blood vessel that balloons out and bursts. […] These weak spots develop over time due to personal risk factors like high blood pressure, smoking, genetic predisposition, and connective tissue disorders that weaken arterial walls and, in turn, encourage aneurysms to form. […] Head injuries from falls, vehicle accidents, or other trauma can cause blood vessels to tear from impact, leading to bleeding in the subarachnoid space. […] Although less common, arteriovenous malformations (AVMs) can bleed into the subarachnoid space. […] Bacteria or other pathogens can also weaken arterial walls, forming aneurysms that are vulnerable to rupture. […] Other causes of SAH include the use of certain drugs, like cocaine, which causes sudden spikes in blood pressure and increases the risk of an aneurysm rupturing.

• #43 Subarachnoid Hemorrhage – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441958/

  Subarachnoid hemorrhages are life-threatening and result from the accumulation of blood between the arachnoid and pia mater. […] The etiology of SAH can be either nontraumatic (about 85% are secondary to aneurysm rupture) or traumatic in nature. […] Most nontraumatic causes of SAH (~ 85%) are caused by the rupture of an intracranial aneurysm. […] As elucidated earlier, about 85% of nontraumatic SAH cases are secondary to aneurysmal rupture. […] The most common causes of nontraumatic SAH are mentioned below: […] An aneurysmal cause of SAH has similar risk factors associated with aneurysm formation. Hypertension, cigarette smoking, and family history are the most consistently observed risk factors. […] Older age (60 years), posterior circulation location, atherosclerosis, hypertension, and large Intra-arterial aneurysm (IA) size (5 mm) are contributing factors for an IA to rupture. […] Cocaine abuse is associated with aneurysmal and nonaneurysmal SAH. […] Cerebral amyloid angiopathy can cause SAH in older adults. […] Cerebral venous thrombosis, sickle cell disorders, moyamoya disease, cerebral vasculitis, and bleeding disorders are some of the conditions that cause SAH.

• #44 Diagnosis and management of subarachnoid haemorrhage | Nature Communications

  https://www.nature.com/articles/s41467-024-46015-2

  Subarachnoid haemorrhage (SAH), a neurovascular emergency with an incidence in the UK, is approximately 8 per 100,000 population, peaking at 50-60 years and is 1.6 times more common in women than men. The spontaneous rupture of an intracranial aneurysm (80-85%) is the most common cause of SAH. […] History of familial aneurysms (at least one first-degree relative with an intracranial aneurysm) and certain genetic diseases such as autosomal dominant polycystic kidney disease, Ehlers-Danlos syndrome type IV, Marfan syndrome, and neurofibromatosis type 1 have been identified as predisposing factors to cerebral aneurysms. […] The factors associated with an increased risk of rupture of a cerebral aneurysm are hypertension, smoking, cocaine and alcohol usage. The risk of rupture also varies according to the size (7mm) and location, with anterior and posterior aneurysms at a higher risk of rupture than middle cerebral artery (MCA) aneurysms.

• #45 Diagnosis and management of subarachnoid haemorrhage | Nature Communications

  https://www.nature.com/articles/s41467-024-46015-2

  Subarachnoid haemorrhage (SAH), a neurovascular emergency with an incidence in the UK, is approximately 8 per 100,000 population, peaking at 50-60 years and is 1.6 times more common in women than men. The spontaneous rupture of an intracranial aneurysm (80-85%) is the most common cause of SAH. […] History of familial aneurysms (at least one first-degree relative with an intracranial aneurysm) and certain genetic diseases such as autosomal dominant polycystic kidney disease, Ehlers-Danlos syndrome type IV, Marfan syndrome, and neurofibromatosis type 1 have been identified as predisposing factors to cerebral aneurysms. […] The factors associated with an increased risk of rupture of a cerebral aneurysm are hypertension, smoking, cocaine and alcohol usage. The risk of rupture also varies according to the size (7mm) and location, with anterior and posterior aneurysms at a higher risk of rupture than middle cerebral artery (MCA) aneurysms.

• #46 Definition and etiology of subarachnoid hemorrhage | STROKE MANUAL

  https://www.stroke-manual.com/subarachnoid-hemorrhage-definition-etiology/

  the most common causes of SAH are traumatic brain injury and a ruptured cerebral aneurysm (~ 75-80%) […] other causes include arteriovenous malformations (AVMs) and blood disorders; in some cases, the cause remains undetected […] up to 10% of intracranial aneurysms occur in a familial pattern (2 affected first-degree relatives) […] individuals with a family history of aneurysms or SAH have a 2-7 times higher risk compared to the general population […] conditions such as autosomal dominant polycystic kidney disease (ADPKD) and certain connective tissue disorders (Marfan syndrome, Ehlers-Danlos syndrome) are well-known risk factors for intracranial aneurysms.

• #47 Diagnosis and management of subarachnoid haemorrhage | Nature Communications

  https://www.nature.com/articles/s41467-024-46015-2

  Subarachnoid haemorrhage (SAH), a neurovascular emergency with an incidence in the UK, is approximately 8 per 100,000 population, peaking at 50-60 years and is 1.6 times more common in women than men. The spontaneous rupture of an intracranial aneurysm (80-85%) is the most common cause of SAH. […] History of familial aneurysms (at least one first-degree relative with an intracranial aneurysm) and certain genetic diseases such as autosomal dominant polycystic kidney disease, Ehlers-Danlos syndrome type IV, Marfan syndrome, and neurofibromatosis type 1 have been identified as predisposing factors to cerebral aneurysms. […] The factors associated with an increased risk of rupture of a cerebral aneurysm are hypertension, smoking, cocaine and alcohol usage. The risk of rupture also varies according to the size (7mm) and location, with anterior and posterior aneurysms at a higher risk of rupture than middle cerebral artery (MCA) aneurysms.

• #48 Definition and etiology of subarachnoid hemorrhage | STROKE MANUAL

  https://www.stroke-manual.com/subarachnoid-hemorrhage-definition-etiology/

  the most common causes of SAH are traumatic brain injury and a ruptured cerebral aneurysm (~ 75-80%) […] other causes include arteriovenous malformations (AVMs) and blood disorders; in some cases, the cause remains undetected […] up to 10% of intracranial aneurysms occur in a familial pattern (2 affected first-degree relatives) […] individuals with a family history of aneurysms or SAH have a 2-7 times higher risk compared to the general population […] conditions such as autosomal dominant polycystic kidney disease (ADPKD) and certain connective tissue disorders (Marfan syndrome, Ehlers-Danlos syndrome) are well-known risk factors for intracranial aneurysms.

• #49 Pediatric Subarachnoid Hemorrhage: Rare Events with Important Implications | Auctores

  https://www.auctoresonline.org/article/pediatric-subarachnoid-hemorrhage-rare-events-with-important-implications

  Rupture of an aneurysm is the leading cause of subarachnoid hemorrhage (SAH) which results in accumulation of blood between the arachnoid and pia mater, consequently increasing intracranial pressure. […] Aneurysms, arteriovenous malformations, and pediatric tumors are the most common causes of pSAH. Increased predilection is based on genetics or underlying infection. […] Common causes of pSAH include genetic and infectious etiologies that predispose children to develop aneurysms. […] Genetic and infectious predispositions include: Alagille syndrome, sickle cell anemia, irradiation, cardiac myxoma (Carney complex), HIV/AIDS, tuberous sclerosis, vascular anomalies, Marfan syndrome, syphilis, Moya Moya disease, pseudoxanthoma elasticum, type IV Ehlers-Danlos syndrome, fibromuscular dysplasia, von Hippel-Lindau syndrome, arterio-venous malformations secondary to Osler-Weber-Rendu Syndrome, hypertension, coarctation of the aorta and polycystic kidney disease.

• #50 Diagnosis and management of subarachnoid haemorrhage | Nature Communications

  https://www.nature.com/articles/s41467-024-46015-2

  Subarachnoid haemorrhage (SAH), a neurovascular emergency with an incidence in the UK, is approximately 8 per 100,000 population, peaking at 50-60 years and is 1.6 times more common in women than men. The spontaneous rupture of an intracranial aneurysm (80-85%) is the most common cause of SAH. […] History of familial aneurysms (at least one first-degree relative with an intracranial aneurysm) and certain genetic diseases such as autosomal dominant polycystic kidney disease, Ehlers-Danlos syndrome type IV, Marfan syndrome, and neurofibromatosis type 1 have been identified as predisposing factors to cerebral aneurysms. […] The factors associated with an increased risk of rupture of a cerebral aneurysm are hypertension, smoking, cocaine and alcohol usage. The risk of rupture also varies according to the size (7mm) and location, with anterior and posterior aneurysms at a higher risk of rupture than middle cerebral artery (MCA) aneurysms.

• #51 Diagnosis and management of subarachnoid haemorrhage | Nature Communications

  https://www.nature.com/articles/s41467-024-46015-2

  Subarachnoid haemorrhage (SAH), a neurovascular emergency with an incidence in the UK, is approximately 8 per 100,000 population, peaking at 50-60 years and is 1.6 times more common in women than men. The spontaneous rupture of an intracranial aneurysm (80-85%) is the most common cause of SAH. […] History of familial aneurysms (at least one first-degree relative with an intracranial aneurysm) and certain genetic diseases such as autosomal dominant polycystic kidney disease, Ehlers-Danlos syndrome type IV, Marfan syndrome, and neurofibromatosis type 1 have been identified as predisposing factors to cerebral aneurysms. […] The factors associated with an increased risk of rupture of a cerebral aneurysm are hypertension, smoking, cocaine and alcohol usage. The risk of rupture also varies according to the size (7mm) and location, with anterior and posterior aneurysms at a higher risk of rupture than middle cerebral artery (MCA) aneurysms.

• #52 Definition and etiology of subarachnoid hemorrhage | STROKE MANUAL

  https://www.stroke-manual.com/subarachnoid-hemorrhage-definition-etiology/

  subarachnoid hemorrhage (SAH) is a clinical syndrome caused by bleeding into the subarachnoid space (located between the arachnoid membrane and the pia mater surrounding the brain) […] traumatic SAH occurs as a result of traumatic brain injury (TBI) […] non-traumatic SAH often results from the rupture of a cerebral aneurysm (~75-85% of cases) or, less frequently, from an arteriovenous malformation (AVM) […] while hemodynamic stress at arterial bifurcations and bends is a major factor in aneurysm formation, aneurysms can also have a genetic or congenital component […] many hereditary connective tissue disorders are linked to aneurysm formation due to structural defects in the arterial wall (e.g., coarctation of the aorta, Marfan syndrome, Ehlers-Danlos syndrome, fibromuscular dysplasia, polycystic kidney disease)

• #53 Diagnosis and management of subarachnoid haemorrhage | Nature Communications

  https://www.nature.com/articles/s41467-024-46015-2

  Subarachnoid haemorrhage (SAH), a neurovascular emergency with an incidence in the UK, is approximately 8 per 100,000 population, peaking at 50-60 years and is 1.6 times more common in women than men. The spontaneous rupture of an intracranial aneurysm (80-85%) is the most common cause of SAH. […] History of familial aneurysms (at least one first-degree relative with an intracranial aneurysm) and certain genetic diseases such as autosomal dominant polycystic kidney disease, Ehlers-Danlos syndrome type IV, Marfan syndrome, and neurofibromatosis type 1 have been identified as predisposing factors to cerebral aneurysms. […] The factors associated with an increased risk of rupture of a cerebral aneurysm are hypertension, smoking, cocaine and alcohol usage. The risk of rupture also varies according to the size (7mm) and location, with anterior and posterior aneurysms at a higher risk of rupture than middle cerebral artery (MCA) aneurysms.

• #54 Subarachnoid Hemorrhage: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/1164341-overview

  Significant incidence of multiple aneurysms in patients with SAH (15%). […] The association of aneurysms with specific congenital diseases (eg, coarctation of the aorta, Marfan syndrome, Ehlers-Danlos syndrome, fibromuscular dysplasia, polycystic kidney disease). […] Acquired factors thought to be associated with aneurysmal formation include atherosclerosis, hypertension, advancing age, smoking, hemodynamic stress. […] Less common causes of SAH include fusiform and mycotic aneurysms, fibromuscular dysplasia, blood dyscrasias, moyamoya disease, infection, neoplasm, trauma (fracture at the base of the skull leading to internal carotid aneurysm), amyloid angiopathy (especially in elderly people), vasculitis. […] Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by recurrent thunderclap headaches and reversible segmental multifocal cerebral artery narrowing, and it results in SAH in more than 30% of cases.

• #55 Pediatric Subarachnoid Hemorrhage: Rare Events with Important Implications | Auctores

  https://www.auctoresonline.org/article/pediatric-subarachnoid-hemorrhage-rare-events-with-important-implications

  Rupture of an aneurysm is the leading cause of subarachnoid hemorrhage (SAH) which results in accumulation of blood between the arachnoid and pia mater, consequently increasing intracranial pressure. […] Aneurysms, arteriovenous malformations, and pediatric tumors are the most common causes of pSAH. Increased predilection is based on genetics or underlying infection. […] Common causes of pSAH include genetic and infectious etiologies that predispose children to develop aneurysms. […] Genetic and infectious predispositions include: Alagille syndrome, sickle cell anemia, irradiation, cardiac myxoma (Carney complex), HIV/AIDS, tuberous sclerosis, vascular anomalies, Marfan syndrome, syphilis, Moya Moya disease, pseudoxanthoma elasticum, type IV Ehlers-Danlos syndrome, fibromuscular dysplasia, von Hippel-Lindau syndrome, arterio-venous malformations secondary to Osler-Weber-Rendu Syndrome, hypertension, coarctation of the aorta and polycystic kidney disease.

• #56 Pediatric Subarachnoid Hemorrhage: Rare Events with Important Implications | Auctores

  https://www.auctoresonline.org/article/pediatric-subarachnoid-hemorrhage-rare-events-with-important-implications

  Rupture of an aneurysm is the leading cause of subarachnoid hemorrhage (SAH) which results in accumulation of blood between the arachnoid and pia mater, consequently increasing intracranial pressure. […] Aneurysms, arteriovenous malformations, and pediatric tumors are the most common causes of pSAH. Increased predilection is based on genetics or underlying infection. […] Common causes of pSAH include genetic and infectious etiologies that predispose children to develop aneurysms. […] Genetic and infectious predispositions include: Alagille syndrome, sickle cell anemia, irradiation, cardiac myxoma (Carney complex), HIV/AIDS, tuberous sclerosis, vascular anomalies, Marfan syndrome, syphilis, Moya Moya disease, pseudoxanthoma elasticum, type IV Ehlers-Danlos syndrome, fibromuscular dysplasia, von Hippel-Lindau syndrome, arterio-venous malformations secondary to Osler-Weber-Rendu Syndrome, hypertension, coarctation of the aorta and polycystic kidney disease.

• #57 Subarachnoid hemorrhage – Wikipedia

  https://en.wikipedia.org/wiki/Subarachnoid_hemorrhage

  Bleeding into the brain’s subarachnoid space […] SAH may occur as a result of a head injury or spontaneously, usually from a ruptured cerebral aneurysm. […] In 85 percent of spontaneous cases the cause is a cerebral aneurysm, a weakness in the wall of one of the arteries in the brain that becomes enlarged. […] Cocaine abuse and sickle cell anemia (usually in children) and, rarely, anticoagulant therapy, problems with blood clotting and pituitary apoplexy can also result in SAH. […] Most cases of SAH are due to trauma such as a blow to the head. […] Traumatic SAH usually occurs near the site of a skull fracture or intracerebral contusion. […] In 15-20 percent of cases of spontaneous SAH, no aneurysm is detected on the first angiogram. […] The remainder are due to other disorders affecting the blood vessels (such as cerebral arteriovenous malformations), disorders of the blood vessels in the spinal cord, and bleeding into various tumors.

• #58 Subarachnoid hemorrhage – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/subarachnoid-hemorrhage/

  Subarachnoid hemorrhage (SAH) refers to bleeding into the subarachnoid space. While SAH is often caused by trauma, 510% of cases are nontraumatic or spontaneous, in which case they are often due to the rupture of an aneurysm involving the circle of Willis (aneurysmal SAH). […] Ruptured cerebral aneurysm is the most common cause of nontraumatic SAH. […] Nontraumatic SAH is responsible for 510% of all strokes. […] Traumatic SAH: traumatic brain injury. […] Nontraumatic (spontaneous) SAH causes include ruptured intracranial aneurysms, which most commonly occur in the circle of Willis. […] Berry aneurysms account for approx. 80% of cases of nontraumatic SAH. […] Triggers: most cases unknown, may be triggered by an acute rise in blood pressure; (e.g., caffeine consumption, fits of anger, physical exertion). […] Risk factors include smoking, hypertension, high alcohol consumption, family history of SAH, methamphetamine and cocaine use, large aneurysms, and aneurysm location.

• #59 Subarachnoid Hemorrhage: Causes, Symptoms, Treatment

  https://www.emedicinehealth.com/what_causes_a_subarachnoid_hemorrhage/article_em.htm

  Most (about 80% of) subarachnoid hemorrhages are caused by a ruptured brain aneurysm. […] About 80% of subarachnoid hemorrhages are caused by a ruptured brain aneurysm. A brain aneurysm is a bulge in a weak spot in a blood vessel wall, in the brain. […] It’s unknown why brain aneurysms develop, but risk factors include: Smoking, High blood pressure (hypertension), Excessive alcohol consumption, Severe head injury, Family history of brain aneurysms, Autosomal dominant polycystic kidney disease (ADPKD). […] Subarachnoid hemorrhages sometimes occur during physical effort or straining, such as: Coughing, Straining to have a bowel movement, Lifting heavy objects, Vigorous sex. […] A subarachnoid hemorrhage is a type of stroke usually caused by a burst blood vessel in the brain (a ruptured brain aneurysm).

• #60 Subarachnoid haemorrhage | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/subarachnoid-haemorrhage

  A subarachnoid haemorrhage is any bleed located underneath one of the protective layers of the brain known as the arachnoid layer. […] Causes which may increase the risk of aneurysm rupture or AVM rupture include high blood pressure, physical exertion and emotional stress. Other causes of SAH can be traumatic, such as head injury occurring from a fall, car accident or blow to the head. […] Some of the causes include: […] Cerebral aneurysm – a weakening of any part of a blood vessel network of the brain. This weakening causes the blood vessel to stretch and deform, usually into the shape of a balloon. In this state, the blood vessel is unstable and can easily rupture. Contributing factors to the formation of a cerebral aneurysm are thought to include hypertension and atherosclerosis. […] Arteriovenous malformation (AVM) – a condition where blood vessels within the brain cluster together and form abnormal connections. The abnormal formation is very weak and prone to bleeding. […] Trauma – any severe blow to the head may rupture blood vessels within the brain.

• #61 Subarachnoid Hemorrhage: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/1164341-overview

  Significant incidence of multiple aneurysms in patients with SAH (15%). […] The association of aneurysms with specific congenital diseases (eg, coarctation of the aorta, Marfan syndrome, Ehlers-Danlos syndrome, fibromuscular dysplasia, polycystic kidney disease). […] Acquired factors thought to be associated with aneurysmal formation include atherosclerosis, hypertension, advancing age, smoking, hemodynamic stress. […] Less common causes of SAH include fusiform and mycotic aneurysms, fibromuscular dysplasia, blood dyscrasias, moyamoya disease, infection, neoplasm, trauma (fracture at the base of the skull leading to internal carotid aneurysm), amyloid angiopathy (especially in elderly people), vasculitis. […] Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by recurrent thunderclap headaches and reversible segmental multifocal cerebral artery narrowing, and it results in SAH in more than 30% of cases.

• #62 Convexity subarachnoid haemorrhage: a practical guide | Practical Neurology

  https://pn.bmj.com/content/23/5/368

  Atraumatic convexity subarachnoid haemorrhage describes spontaneous bleeding into the convexities of the brain sulci without parenchymal involvement. Its many causes include reversible cerebral vasoconstriction syndrome, cerebral sinus venous thrombosis, posterior reversible encephalopathy syndrome and (in older people) cerebral amyloid angiopathy. […] The causes of cSAH in younger people include reversible cerebral vasoconstriction syndrome (RCVS), posterior reversible encephalopathy syndrome (PRES), cerebral sinus venous thrombosis and others. In people aged over 60 years, cerebral amyloid angiopathy (CAA) is a common cause. […] CAA probably results from an imbalance between the production and clearance of A, a breakdown product of A precursor protein. Excessive A accumulates in the small leptomeningeal and cortical blood vessels, which become brittle and fragile, allowing blood leakage into the subarachnoid space. […] The recurrent nature of CAA-related transient focal neurological episodes is probably due to cortical spreading depolarisation.

• #63 Isolated Acute Nontraumatic Cortical Subarachnoid Hemorrhage | American Journal of Neuroradiology

  http://www.ajnr.org/content/31/8/1355

  The exact mechanism of SAH associated with CVT is not known but may result from venous hypertension and subsequent rupture of dilated thin-walled subarachnoid cortical veins. […] Although vascular malformations are classic causes of hemorrhagic stroke, pial and dural arteriovenous malformations typically present with parenchymal hematoma or basal SAH and only rarely with isolated cSAH. […] RCVS is a new name unifying a spectrum of separately described overlapping pathologies that have some fundamental clinical and imaging features in common: severe headache, variable neurologic deficits, and reversible arterial abnormalities (dilations and stenoses). […] This highly heterogeneous group of disorders might be complicated by cerebral hemorrhage (including isolated cSAH) due to inflammation of the wall of the blood vessels.

• #64 Subarachnoid Hemorrhage, Vasospasm, and Delayed Cerebral Ischemia

  https://practicalneurology.com/articles/2019-jan/subarachnoid-hemorrhage-vasospasm-and-delayed-cerebral-ischemia

  Subarachnoid hemorrhage (SAH) represents a detrimental cerebrovascular disease with high mortality and morbidity. Direct bleeding effects are the most common underlying cause of mortality, and death, in most cases, occurs within 2 days of an initial event. […] In this new era, the secondary consequences of SAH – vasospasm and delayed cerebral infarction (DCI) – represent important causes of disability and death. […] Cerebral vasospasm – the narrowing of the cerebral arteries after SAH – is a common complication that occurs in up to 70% of patients and can be seen with radiographic and ultrasound imaging. […] Vasospasm is triggered by the breakdown of blood products accumulating in the subarachnoid and perivascular spaces. […] There are several reported predictors of vasospasm, including the amount of blood on CT scan, the presence of intraventricular hemorrhage, neurologic impairment as assessed by World Federation of Neurosurgical Societies (WFNS) scale, hypertension and temperature on admission, age, smoking, and aneurysm location. […] Of all these factors, location and thickness of the blood clot as graded by the Fisher CT scale (grade 3/4), are consistently reported as the most powerful predictors of vasospasm.

• #65 Subarachnoid Hemorrhage (SAH) – EMCrit Project

  https://emcrit.org/ibcc/sah/

  Clinical characteristics of perimesencephalic SAH include: Initial neurologic examination is generally normal. […] The overall prognosis is better than for aneurysmal SAH. […] Rebleeding occurs in ~15% of patients. When it occurs, the mortality rate is enormous (~50%). […] Most rebleeding occurs within the first six hours following admission.(30516599) If the aneurysm is not secured, the risk of rebleeding will continue to gradually increase over time (e.g., ~1% daily increase over the first month).(Shutter 2019) […] Risk factors for rebleeding include: Poor grade SAH. […] Promptly securing the aneurysm (either via surgical clipping or endovascular occlusion) reduces the risk of rebleeding.

• #66 Subarachnoid haemorrhage: diagnosis, causes and management – PubMed

  https://pubmed.ncbi.nlm.nih.gov/11157554/

  The cause of SAH is a ruptured aneurysm in 85% of cases, non-aneurysmal perimesencephalic haemorrhage (with excellent prognosis) in 10%, and a variety of rare conditions in 5%. […] A poor clinical condition on admission may be caused by a remediable complication of the initial bleed or a recurrent haemorrhage in the form of intracranial haematoma, acute hydrocephalus or global brain ischaemia.

• #67 Subarachnoid haemorrhage: diagnosis, causes and management – PubMed

  https://pubmed.ncbi.nlm.nih.gov/11157554/

  The cause of SAH is a ruptured aneurysm in 85% of cases, non-aneurysmal perimesencephalic haemorrhage (with excellent prognosis) in 10%, and a variety of rare conditions in 5%. […] A poor clinical condition on admission may be caused by a remediable complication of the initial bleed or a recurrent haemorrhage in the form of intracranial haematoma, acute hydrocephalus or global brain ischaemia.

• #68 Subarachnoid Hemorrhage, Vasospasm, and Delayed Cerebral Ischemia

  https://practicalneurology.com/articles/2019-jan/subarachnoid-hemorrhage-vasospasm-and-delayed-cerebral-ischemia

  Subarachnoid hemorrhage (SAH) represents a detrimental cerebrovascular disease with high mortality and morbidity. Direct bleeding effects are the most common underlying cause of mortality, and death, in most cases, occurs within 2 days of an initial event. […] In this new era, the secondary consequences of SAH – vasospasm and delayed cerebral infarction (DCI) – represent important causes of disability and death. […] Cerebral vasospasm – the narrowing of the cerebral arteries after SAH – is a common complication that occurs in up to 70% of patients and can be seen with radiographic and ultrasound imaging. […] Vasospasm is triggered by the breakdown of blood products accumulating in the subarachnoid and perivascular spaces. […] There are several reported predictors of vasospasm, including the amount of blood on CT scan, the presence of intraventricular hemorrhage, neurologic impairment as assessed by World Federation of Neurosurgical Societies (WFNS) scale, hypertension and temperature on admission, age, smoking, and aneurysm location. […] Of all these factors, location and thickness of the blood clot as graded by the Fisher CT scale (grade 3/4), are consistently reported as the most powerful predictors of vasospasm.

• #69 Subarachnoid Hemorrhage, Vasospasm, and Delayed Cerebral Ischemia

  https://practicalneurology.com/articles/2019-jan/subarachnoid-hemorrhage-vasospasm-and-delayed-cerebral-ischemia

  Vasospasm can result in DCI, which refers to a new focal neurologic deficit or a persistent (1 hour) decline in the patients Glasgow Coma Scale (GCS) score by 2 or more points according to a recent consensus definition. […] Although DCI is highly correlated with vasospasm, there may be other contributors including microcirculatory constriction, microthrombosis, cortical spreading depression, and delayed cellular apoptosis. […] Vasospasm and DCI contribute substantially to mortality and morbidity of patients who experienced SAH. […] Because vasospasm is a more complex pathophysiologic process than previously understood, more research regarding multimodal approaches and new therapeutic targets is needed.

• #70 Subarachnoid Hemorrhage: Causes, Symptoms, Treatment

  https://www.emedicinehealth.com/what_causes_a_subarachnoid_hemorrhage/article_em.htm

  A subarachnoid hemorrhage is diagnosed in the hospital with tests such as: Computerized tomography (CT) scan to check for signs of a brain hemorrhage, Lumbar puncture to sample cerebrospinal fluid that surrounds the brain and spinal cord to check for signs of bleeding. […] If a subarachnoid hemorrhage is confirmed or strongly suspected, patients are usually transferred to a specialist neuroscience unit that may include neurologists, neurosurgeons, neuroradiologists, and neurointensivists. […] Treatment for a subarachnoid hemorrhage involves stopping the bleeding, which may be done by: Surgery to place a small clip on the blood vessel to stop blood from leaking into the brain, An endovascular coil placed in the artery in that is bleeding. […] A subarachnoid hemorrhage can lead to complications such as: Rebleeding, Vasospasm (also called delayed cerebral ischemia), Hydrocephalus, Long-term complications.

• #71 Subarachnoid Hemorrhage, Vasospasm, and Delayed Cerebral Ischemia

  https://practicalneurology.com/articles/2019-jan/subarachnoid-hemorrhage-vasospasm-and-delayed-cerebral-ischemia

  Subarachnoid hemorrhage (SAH) represents a detrimental cerebrovascular disease with high mortality and morbidity. Direct bleeding effects are the most common underlying cause of mortality, and death, in most cases, occurs within 2 days of an initial event. […] In this new era, the secondary consequences of SAH – vasospasm and delayed cerebral infarction (DCI) – represent important causes of disability and death. […] Cerebral vasospasm – the narrowing of the cerebral arteries after SAH – is a common complication that occurs in up to 70% of patients and can be seen with radiographic and ultrasound imaging. […] Vasospasm is triggered by the breakdown of blood products accumulating in the subarachnoid and perivascular spaces. […] There are several reported predictors of vasospasm, including the amount of blood on CT scan, the presence of intraventricular hemorrhage, neurologic impairment as assessed by World Federation of Neurosurgical Societies (WFNS) scale, hypertension and temperature on admission, age, smoking, and aneurysm location. […] Of all these factors, location and thickness of the blood clot as graded by the Fisher CT scale (grade 3/4), are consistently reported as the most powerful predictors of vasospasm.

• #72 Subarachnoid Hemorrhage, Vasospasm, and Delayed Cerebral Ischemia

  https://practicalneurology.com/articles/2019-jan/subarachnoid-hemorrhage-vasospasm-and-delayed-cerebral-ischemia

  Vasospasm can result in DCI, which refers to a new focal neurologic deficit or a persistent (1 hour) decline in the patients Glasgow Coma Scale (GCS) score by 2 or more points according to a recent consensus definition. […] Although DCI is highly correlated with vasospasm, there may be other contributors including microcirculatory constriction, microthrombosis, cortical spreading depression, and delayed cellular apoptosis. […] Vasospasm and DCI contribute substantially to mortality and morbidity of patients who experienced SAH. […] Because vasospasm is a more complex pathophysiologic process than previously understood, more research regarding multimodal approaches and new therapeutic targets is needed.

• #73 Pediatric Subarachnoid Hemorrhage: Rare Events with Important Implications | Auctores

  https://www.auctoresonline.org/article/pediatric-subarachnoid-hemorrhage-rare-events-with-important-implications

  Pediatric aneurysms differ from classical adult aneurysms; they are rarer, tend to be larger, have an overall male predominance, are commonly caused by infection or trauma, and have increased predilection for the posterior circulation. […] Pediatric SAH may be treated effectively by either microsurgery or endovascular techniques such as coil embolization whereby an aneurysm is stabilized to prevent rupture by placing a coil that prevents enlarging of false lumen. […] SAH is associated with trauma, infection, and vascular abnormalities in the pediatric population, and it requires high levels of care during management and after discharge.

• #74 Pediatric Subarachnoid Hemorrhage: Rare Events with Important Implications | Auctores

  https://www.auctoresonline.org/article/pediatric-subarachnoid-hemorrhage-rare-events-with-important-implications

  Rupture of an aneurysm is the leading cause of subarachnoid hemorrhage (SAH) which results in accumulation of blood between the arachnoid and pia mater, consequently increasing intracranial pressure. […] Aneurysms, arteriovenous malformations, and pediatric tumors are the most common causes of pSAH. Increased predilection is based on genetics or underlying infection. […] Common causes of pSAH include genetic and infectious etiologies that predispose children to develop aneurysms. […] Genetic and infectious predispositions include: Alagille syndrome, sickle cell anemia, irradiation, cardiac myxoma (Carney complex), HIV/AIDS, tuberous sclerosis, vascular anomalies, Marfan syndrome, syphilis, Moya Moya disease, pseudoxanthoma elasticum, type IV Ehlers-Danlos syndrome, fibromuscular dysplasia, von Hippel-Lindau syndrome, arterio-venous malformations secondary to Osler-Weber-Rendu Syndrome, hypertension, coarctation of the aorta and polycystic kidney disease.

• #75 Subarachnoid Hemorrhage in Newborns | ABC Law Centers: Birth Injury Lawyers

  https://www.abclawcenters.com/practice-areas/infant-intracranial-hemorrhages/subarachnoid-hemorrhage-in-newborns/

  A subarachnoid hemorrhage is one of the most common types of intracranial hemorrhage (brain bleed), and is characterized by the pooling of blood between the arachnoid and the pia mater. In other words, it is bleeding between the innermost two membranes that cover the brain. These hemorrhages occur when bridging blood vessels or dural sinuses rupture (1). […] In newborns, subarachnoid hemorrhages can result from either birth trauma (excessive mechanical force on the baby during birth) or hypoxic-ischemic injury (lack of oxygenated blood flow to the brain) (2, 3). The former is a more common cause in term infants, and the latter in preterm infants (2). […] Some factors that can cause birth trauma include mismanagement of an abnormal fetal presentation, improper use of forceps or vacuum extractors, attempts to vaginally deliver babies that will not fit through the mother’s pelvis (see macrosomia and cephalopelvic disproportion), and overuse of the labor-assisting drugs Pitocin and Cytotec. Hypoxia can result from all of the same issues, as well as umbilical cord injuries, uterine rupture, placental abruption, and more. Both birth trauma and hypoxia are often avoidable, and may be caused by medical malpractice.

• #76 Subarachnoid Hemorrhage in Newborns | ABC Law Centers: Birth Injury Lawyers

  https://www.abclawcenters.com/practice-areas/infant-intracranial-hemorrhages/subarachnoid-hemorrhage-in-newborns/

  A subarachnoid hemorrhage is one of the most common types of intracranial hemorrhage (brain bleed), and is characterized by the pooling of blood between the arachnoid and the pia mater. In other words, it is bleeding between the innermost two membranes that cover the brain. These hemorrhages occur when bridging blood vessels or dural sinuses rupture (1). […] In newborns, subarachnoid hemorrhages can result from either birth trauma (excessive mechanical force on the baby during birth) or hypoxic-ischemic injury (lack of oxygenated blood flow to the brain) (2, 3). The former is a more common cause in term infants, and the latter in preterm infants (2). […] Some factors that can cause birth trauma include mismanagement of an abnormal fetal presentation, improper use of forceps or vacuum extractors, attempts to vaginally deliver babies that will not fit through the mother’s pelvis (see macrosomia and cephalopelvic disproportion), and overuse of the labor-assisting drugs Pitocin and Cytotec. Hypoxia can result from all of the same issues, as well as umbilical cord injuries, uterine rupture, placental abruption, and more. Both birth trauma and hypoxia are often avoidable, and may be caused by medical malpractice.

• #77 Spontaneous Non-Aneurysmal Convexity Subarachnoid Hemorrhage: A Scoping Review of Different Etiologies beyond Cerebral Amyloid Angiopathy

  https://www.mdpi.com/2077-0383/13/15/4382

  Spontaneous convexity subarachnoid hemorrhage (cSAH) is a vascular disease different from aneurysmal SAH in neuroimaging pattern, causes, and prognosis. Several causes might be considered in individual patients, with a limited value of the patient’s age for discriminating among these causes. Cerebral amyloid angiopathy (CAA) is the most prevalent cause in people > 60 years, but reversible cerebral vasoconstriction syndrome (RCVS) has to be considered in young people. […] cSAH might have different underlying causes, and age is important to select the most probable causes. In younger people, the most probable causes include reversible cerebral vasoconstriction syndrome (RCVS) with or without posterior reversible encephalopathy syndrome (PRES), cerebral venous thrombosis (CVT), and others rarer diseases. In people > 60 years, cerebral amyloid angiopathy (CAA) is the most common cause.

• #78 Spontaneous Non-Aneurysmal Convexity Subarachnoid Hemorrhage: A Scoping Review of Different Etiologies beyond Cerebral Amyloid Angiopathy

  https://www.mdpi.com/2077-0383/13/15/4382

  Spontaneous convexity subarachnoid hemorrhage (cSAH) is a vascular disease different from aneurysmal SAH in neuroimaging pattern, causes, and prognosis. Several causes might be considered in individual patients, with a limited value of the patient’s age for discriminating among these causes. Cerebral amyloid angiopathy (CAA) is the most prevalent cause in people > 60 years, but reversible cerebral vasoconstriction syndrome (RCVS) has to be considered in young people. […] cSAH might have different underlying causes, and age is important to select the most probable causes. In younger people, the most probable causes include reversible cerebral vasoconstriction syndrome (RCVS) with or without posterior reversible encephalopathy syndrome (PRES), cerebral venous thrombosis (CVT), and others rarer diseases. In people > 60 years, cerebral amyloid angiopathy (CAA) is the most common cause.

• #79 Spontaneous Non-Aneurysmal Convexity Subarachnoid Hemorrhage: A Scoping Review of Different Etiologies beyond Cerebral Amyloid Angiopathy

  https://www.mdpi.com/2077-0383/13/15/4382

  CAA is one of the main causes of spontaneous cSAH, and the Boston 2.0 criteria added cSAH as a hemorrhagic manifestation of the disease suitable for diagnosis. […] The prognosis for CAA-related cortical subarachnoid hemorrhage (cSAH) has been detailed in a recent study, revealing the following risks per patient-year: intracerebral hemorrhage (ICH) at 13.2%, recurrent cSAH at 11.1%, combined ICH or cSAH at 21.4%, ischemic stroke at 5.1%, and mortality at 8.3%. […] Extracranial or intracranial artery stenosis, including internal carotid artery (ICA) or middle cerebral artery (MCA) stenosis, is rarely documented in cases of cSAH. […] cSAH is a rare finding in infective endocarditis (IE), occurring in about 5% of cases. […] CVT has long been recognized as a cause of parenchymal hemorrhage. cSAH, either isolated or in combination with parenchymal hemorrhages, represents a rare manifestation of CVT, accounting for 6.5% of patients in the largest series.

• #80 Subarachnoid Hemorrhage | Expert Surgeon | Aaron Cohen-Gadol, MD

  https://www.aaroncohen-gadol.com/en/patients/subarachnoid-hemorrhage

  A subarachnoid hemorrhage is a life-threatening condition defined as bleeding into the space around your brain. This is most commonly caused by traumatic brain injury or a ruptured brain aneurysm. […] Subarachnoid hemorrhage can be caused by rupture of an aneurysm, arteriovenous malformation, or traumatic brain injury. […] In non-traumatic cases, subarachnoid hemorrhage is most often due to a brain aneurysm rupture. Bleeding can also be caused by an arteriovenous malformation, the use of blood thinners, or other bleeding disorders. […] Trauma is the most common cause of subarachnoid hemorrhage. In non-traumatic cases, ruptured aneurysms are the major cause and account for 85% of patients. […] Subarachnoid hemorrhage risk factors include unruptured aneurysms, high blood pressure, history of polycystic kidney disease, connective tissue and autoimmune disorders, smoking, and the use of illicit drugs.

• #81 Subarachnoid Hemorrhage, Vasospasm, and Delayed Cerebral Ischemia

  https://practicalneurology.com/articles/2019-jan/subarachnoid-hemorrhage-vasospasm-and-delayed-cerebral-ischemia

  Vasospasm can result in DCI, which refers to a new focal neurologic deficit or a persistent (1 hour) decline in the patients Glasgow Coma Scale (GCS) score by 2 or more points according to a recent consensus definition. […] Although DCI is highly correlated with vasospasm, there may be other contributors including microcirculatory constriction, microthrombosis, cortical spreading depression, and delayed cellular apoptosis. […] Vasospasm and DCI contribute substantially to mortality and morbidity of patients who experienced SAH. […] Because vasospasm is a more complex pathophysiologic process than previously understood, more research regarding multimodal approaches and new therapeutic targets is needed.

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