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If a subarachnoid haemorrhage is suspected then a computerised tomography (CT) scan should be performed as soon as possible. However, they may not last long, and of course they may not be recognised as possibly serious by doctors or patients. These symptoms may be caused by early small leaks of blood from the aneurysm as it starts to burst (rupture).
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In 1 in 3 patients this will be the only symptom (the rest will have other symptoms as described below).The most characteristic feature is a sudden explosive headache.What are the symptoms of subarachnoid haemorrhage? Headache This can occur either due to infection or to conditions affecting the immune system. Vasculitis, when blood vessels inside the brain become swollen and inflamed.Abnormal blood vessels such as those that may be present in a brain tumour.Head and neck trauma, when bleeding from injury to the brain or the structures around it can track into the subarachnoid space.Other causes of SAH, accounting for fewer than 2 out of every 10 cases, include: These conditions cause only 1-2 in every 100 cases of SAH. These include autosomal dominant polycystic kidney disease (ADPKD). Certain inherited conditions which cause weakening of the blood vessels.
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Rupture is more likely to occur if the elastic tissue in the walls of the berry aneurysm is weakened or strained by: Larger berry aneurysms (bigger than 7 mm) are more likely to rupture (smaller ones can grow larger over time). However, an SAH rupturing is a relatively rare event. About 1 in every 25 adults will have one or more berry aneurysms. More than 8 out of 10 cases of SAH are caused by the bursting (rupture) of berry aneurysms. It is a very disabling and dangerous type of stroke and it tends to affect younger patients more than other strokes.
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This makes SAH relatively rare - but hugely important.SAH causes around 6 out of 100 of all strokes.Around 6-10 people of every 100,000 per year will have an SAH.First-degree relatives of people who have had an SAH are at greater risk.Patients who smoke, use excessive alcohol or have high blood pressure are at greater risk.The condition is also more common in Finland and Japan, where the rates are around three times those in Europe.Patients of African descent are slightly more commonly affected than patients of Caucasian descent.Women are affected slightly more often than men.SAH usually affects adults under the age of 60 years, with the average age of affected patients around 50 years.Who is affected by subarachnoid haemorrhage? This is more likely if the bleed is small, if initial symptoms are less severe and if the patient is younger. About 1 in 4 people survive SAH well enough to live independently. This is due to the damage caused to the brain by the initial bleeding and by the shortage of oxygen to the brain which follows it. Most others will be left with some degree of permanent disability. Many people who have an SAH will die, sometimes before reaching hospital. Subarachnoid haemorrhage (SAH) is a catastrophe. How serious is a subarachnoid haemorrhage?