Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7e
Chapter 160. Spontaneous Subarachnoid and Intracerebral Hemorrhage
Sections: Subarachnoid Hemorrhage, Intracerebral Hemorrhage, References.
Topics Discussed: cerebral hemisphere hemorrhage; subarachnoid hemorrhage.
Excerpt:"Although nontraumatic subarachnoid and intracerebral hemorrhage
account for a relatively small portion of ED visits, a missed diagnosis
can produce devastating results. Early recognition and aggressive
management may improve outcomes.In the U.S., the annual incidence of subarachnoid hemorrhage
is approximately 1 in 10,000 people.3 In contrast
to intracerebral hemorrhage (ICH) and cerebellar infarction, the
incidence of which has been declining since the 1950s, subarachnoid
hemorrhage rates have remained steady. There is significant unexplained
regional variation, with Finland and Japan having the highest reported
incidence at approximately 2.1 per 10,000.4,5 Subarachnoid
hemorrhage is slightly more common in women than in men. The median
age at diagnosis is 50 years. Morbidity and mortality are very high.
Approximately 12% of patients die before reaching medical
care and 50% die within 6 months. More than one third of
patients who survive have a major neurologic deficit.Many different subarachnoid hemorrhage grading scales exist.
Those most widely used include the Hunt and Hess scale and the World
Federation of Neurosurgical Societies scale22 (Table 160-3). A higher..."
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