Abstract
Objectives:The objective of this study was to assess the warning signs and symptoms in patients with spontaneous subarachnoid hemorrhage (SAH).Methods:Patients admitted with spontaneous SAH were enrolled in the study and were asked for their history of frequent warning signs and symptoms as cited in other studies.Results:Overall, 28 cases of spontaneous SAH were identified during the study period. A history of headache as the most frequent warning symptom was present in 64.3% of the cases. Transient loss of consciousness (42.8%), difficulty in walking (21.4%), hemiparesis (14.2%), ocular signs (14.2%) and seizure (3.6%) were the next most frequent symptoms. Hypertension and smoking, the most frequent risk factors for SAH, were found in 39.3 and 32.1% of the cases, respectively.Conclusion:Despite recent advances in neurosurgical techniques, the overall outcome after aneurysmal SAH remains poor. Sudden, severe onset of headache with or without neurologic deficits is an important warning symptom for spontaneous subarachnoid hemorrhage. Further reduction of the possible risk factors and earlier diagnosis on the basis of warning symptoms and treatments are desirable.
This content is limited to qualifying members.
If you have an existing account please login now to access this article or view purchase options.
Create a free account, then purchase this article to download or access it online for 24 hours.
Create a free account, then purchase a subscription to get complete access to all articles for a full year.
References
References1. Suarez JI, Tarr RW, Selman WR. Aneurysmal subarachnoid hemorrhage. N Engl J Med 2006;354:387–396.SuarezJI]]TarrRW]]SelmanWRAneurysmal subarachnoid hemorrhage.N Engl J Med2006354387-3962. Edlow JA, Caplan LR. Avoiding pitfalls in the diagnosis of subarachnoid hemorrhage. N Engl J Med 2000;342:29–36.EdlowJA]]CaplanLRAvoiding pitfalls in the diagnosis of subarachnoid hemorrhage.N Engl J Med200034229-363. Hauerberg J, Andersen BB, Eskesen V, et al. Importance of the recognition of a warning leak as a sign of a ruptured intracranial aneurysm. Acta Neurol Scand 1991;83:61–64.HauerbergJ]]AndersenBB]]EskesenV&etal;Importance of the recognition of a warning leak as a sign of a ruptured intracranial aneurysm.Acta Neurol Scand19918361-644. Jakobsson KE, Saveland H, Hillman J, et al. Warning leak and management outcome in aneurysmal subarachnoid hemorrhage. J neurosurg 1996;85:995–999.JakobssonKE]]SavelandH]]HillmanJ&etal;Warning leak and management outcome in aneurysmal subarachnoid hemorrhage.J neurosurg199685995-9995. Bassi P, Bandera R, Loiero M, et al. Warning signs in subarachnoid hemorrhage: a cooperative study. Acta Neurol Scand 1991;84:277–281.BassiP]]BanderaR]]LoieroM&etal;Warning signs in subarachnoid hemorrhage: a cooperative study.Acta Neurol Scand199184277-2816. Kreiter KT, Copeland D, Bernardini GL, et al. Predictors of cognitive dysfunction after subarachnoid hemorrhage. Stroke 2002;33:200–208.KreiterKT]]CopelandD]]BernardiniGL&etal;Predictors of cognitive dysfunction after subarachnoid hemorrhage.Stroke200233200-2087. Epidemiology of aneurysmal subarachnoid hemorrhage in Australia and New Zeland: incidence and case fatality from the Australasian Cooperative Research on Subarachnoid Hemorrhage Study (ACROSS). Stroke 2000;31:1843–1850.&NA;Epidemiology of aneurysmal subarachnoid hemorrhage in Australia and New Zeland: incidence and case fatality from the Australasian Cooperative Research on Subarachnoid Hemorrhage Study (ACROSS).Stroke2000311843-18508. Wood MJ, Nowitzke AM. Epidemiological aspects of spontaneous subarachnoid hemorrhage in Queensland, Australia. J Clin Neurosci 2005;12:770–774.WoodMJ]]NowitzkeAMEpidemiological aspects of spontaneous subarachnoid hemorrhage in Queensland, Australia.J Clin Neurosci200512770-7749. Reijneveld JC, Wermer M, Boonman Z, et al. Acute confusional state as presenting feature in aneurysmal subarachnoid hemorrhage: frequency and characteristics. J Neurol 2000;247:112–116.ReijneveldJC]]WermerM]]BoonmanZ&etal;Acute confusional state as presenting feature in aneurysmal subarachnoid hemorrhage: frequency and characteristics.J Neurol2000247112-11610. Lledo A, Calandre L, Martinez-Menendez B, et al. Acute headache of recent onset and subarachnoid hemorrhage: a prospective study. Headache 1994;34:172–174.LledoA]]CalandreL]]Martinez-MenendezB&etal;Acute headache of recent onset and subarachnoid hemorrhage: a prospective study.Headache199434172-17411. Mayer PL, Awad IA, Todor R, et al. Misdiagnosis of symptomatic cerebral aneurysm. Prevalence and correlation with outcome at four institutions. Stroke 1996;27:1558–1563.MayerPL]]AwadIA]]TodorR&etal;Misdiagnosis of symptomatic cerebral aneurysm. Prevalence and correlation with outcome at four institutions.Stroke1996271558-156312. Linn FH, Rinkel GJ, Algra A, et al. The notion of “warning leaks” in subarachnoid hemorrhage: are such patients in fact admitted with a rebleed? J Neurol Neurosurg Psychiatry 2000;68:332–336.LinnFH]]RinkelGJ]]AlgraA&etal;The notion of “warning leaks” in subarachnoid hemorrhage: are such patients in fact admitted with a rebleed?J Neurol Neurosurg Psychiatry200068332-33613. Kissela BM, Sauerbeck L, Woo D, et al. Subarachnoid hemorrhage: a preventable disease with a heritable component. Stroke 2002;33:1321–1326.KisselaBM]]SauerbeckL]]WooD&etal;Subarachnoid hemorrhage: a preventable disease with a heritable component.Stroke2002331321-132614. Tsivgoulis G, Spengos K, Vemmos KN, et al. Blood pressure in acute stroke and its prognostic value. Stroke 2004;35:1786–1787.TsivgoulisG]]SpengosK]]VemmosKN&etal;Blood pressure in acute stroke and its prognostic value.Stroke2004351786-1787
