Subarachnoid hemorrhage risk factors

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Subarachnoid Hemorrhage Microchapters


Patient Information





Differentiating Subarachnoid Hemorrhage from other Diseases

Epidemiology and Demographics

Risk Factors


Natural History, Complications and Prognosis


History and Symptoms

Physical Examination

Laboratory Findings



Other Imaging Findings

Other Diagnostic Studies


Medical Therapy


Primary Prevention

Secondary Prevention

AHA/ASA Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage (2012)

Risk Factors/Prevention
Natural History/Outcome
Clinical Manifestations/Diagnosis
Medical Measures to Prevent Rebleeding
Surgical and Endovascular Methods
Hospital Characteristics/Systems of Care
Anesthetic Management
Cerebral Vasospasm and DCI
Seizures Associated With aSAH
Medical Complications

Cost-Effectiveness of Therapy

Future or Investigational Therapies

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Case #1

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Syed Ahsan Hussain, M.D.[2] Cafer Zorkun, M.D., Ph.D. [3]; Sara Mehrsefat, M.D. [4]


Common risk factors in the development of subarachnoid hemorrhage include smoking, hypertension (high blood pressure) and excessive alcohol intake; all are associated with a doubled risk for SAH. Some protection of uncertain significance is conferred by Caucasian ethnicity, hormone replacement therapy, and a higher than normal cholesterol.[1][2]

Risk Factors

Common risk factors in the development of subarachnoid hemorrhage include: [1][2][3][4][5][6][7][8][9][10]


Other risk factors

Trigger factors

Common trigger events in the development of subarachnoid hemorrhage include:[11][12][13]

The highest incidence of rupture occurred while patients were engaged in their daily routines, in the absence of strenuous physical activity.[14]


  1. 1.0 1.1 Feigin VL, Rinkel GJ, Lawes CM; et al. (2005). "Risk factors for subarachnoid hemorrhage: an updated systematic review of epidemiological studies". Stroke. 36 (12): 2773–80. PMID 16282541. doi:10.1161/01.STR.0000190838.02954.e8. 
  2. 2.0 2.1 Feigin VL, Rinkel GJ, Lawes CM, Algra A, Bennett DA, van Gijn J; et al. (2005). "Risk factors for subarachnoid hemorrhage: an updated systematic review of epidemiological studies.". Stroke. 36 (12): 2773–80. PMID 16282541. doi:10.1161/01.STR.0000190838.02954.e8. 
  3. Kernan WN, Viscoli CM, Brass LM, Broderick JP, Brott T, Feldmann E; et al. (2000). "c and the risk of hemorrhagic stroke.". N Engl J Med. 343 (25): 1826–32. PMID 11117973. doi:10.1056/NEJM200012213432501. 
  4. Levine SR, Brust JC, Futrell N, Brass LM, Blake D, Fayad P; et al. (1991). "A comparative study of the cerebrovascular complications of cocaine: alkaloidal versus hydrochloride--a review.". Neurology. 41 (8): 1173–7. PMID 1866000. 
  5. Scotti G, Filizzolo F, Scialfa G, Tampieri D, Versari P (1987). "Repeated subarachnoid hemorrhages from a cervical meningioma. Case report.". J Neurosurg. 66 (5): 779–81. PMID 3572505. doi:10.3171/jns.1987.66.5.0779. 
  6. Navi BB, Reichman JS, Berlin D, Reiner AS, Panageas KS, Segal AZ; et al. (2010). "Intracerebral and subarachnoid hemorrhage in patients with cancer.". Neurology. 74 (6): 494–501. PMC 2830918Freely accessible. PMID 20142616. doi:10.1212/WNL.0b013e3181cef837. 
  7. Risselada R, Straatman H, van Kooten F, Dippel DW, van der Lugt A, Niessen WJ; et al. (2009). "Withdrawal of statins and risk of subarachnoid hemorrhage.". Stroke. 40 (8): 2887–92. PMID 19520985. doi:10.1161/STROKEAHA.109.552760. 
  8. Leppälä JM, Paunio M, Virtamo J, Fogelholm R, Albanes D, Taylor PR; et al. (1999). "Alcohol consumption and stroke incidence in male smokers.". Circulation. 100 (11): 1209–14. PMID 10484542. 
  9. Bederson JB, Awad IA, Wiebers DO, Piepgras D, Haley EC, Brott T; et al. (2000). "Recommendations for the management of patients with unruptured intracranial aneurysms: A statement for healthcare professionals from the Stroke Council of the American Heart Association.". Circulation. 102 (18): 2300–8. PMID 11056108. 
  10. Vlak MH, Rinkel GJ, Greebe P, Greving JP, Algra A (2013). "Lifetime risks for aneurysmal subarachnoid haemorrhage: multivariable risk stratification.". J Neurol Neurosurg Psychiatry. 84 (6): 619–23. PMID 23355806. doi:10.1136/jnnp-2012-303783. 
  11. Anderson C, Ni Mhurchu C, Scott D, Bennett D, Jamrozik K, Hankey G; et al. (2003). "Triggers of subarachnoid hemorrhage: role of physical exertion, smoking, and alcohol in the Australasian Cooperative Research on Subarachnoid Hemorrhage Study (ACROSS).". Stroke. 34 (7): 1771–6. PMID 12775890. doi:10.1161/01.STR.0000077015.90334.A7. 
  12. Penrose RJ (1972). "Life events before subarachnoid haemorrhage.". J Psychosom Res. 16 (5): 329–33. PMID 5071430. 
  13. Vlak MH, Rinkel GJ, Greebe P, van der Bom JG, Algra A (2011). "Trigger factors and their attributable risk for rupture of intracranial aneurysms: a case-crossover study.". Stroke. 42 (7): 1878–82. PMID 21546472. doi:10.1161/STROKEAHA.110.606558. 
  14. Matsuda M, Watanabe K, Saito A, Matsumura K, Ichikawa M. Circum- stances, activities, and events precipitating aneurysmal subarachnoid hemorrhage. J Stroke Cerebrovasc Dis. 2007;16:25–29.