Circumstances and risk factors of aneurysmal subarachnoid hemorrhage

Abstract

The medical records of 567 patients with aneurysmal subarachnold hemorrhage (SAH) were reviewed, and the circumstances and physical activities in which they had been involved immediately before the onset of SAH were analyzed. SAH was most frequent in the winter and occurred least in the autumn. Its peak incidence was observed during 6-9 A.M. and 6-9 P.M., with the lowest incidence during 0-6 A. M. These differences were statistically significant. SAH occurred most frequently while chatting, watching TV or relaxing at home without any strenuous physical activity. When considering the time spent, the highest incidence was found to be related to defecation or micturition. Other daily life activities such as eating/drinking, taking a bath, washing/brushing teeth and (un) dressing carried relatively high incidences. These daily routines tend to be concentrated during the two periods of the day when the peak incidence was observed. Many patients developed SAH while working at their work place or working in the household. When these two categories were combined together as working, they accounted for the highest number of patients, but the incidence itself was lower than average considering the working hours. There was no evidence that aneurysmal SAH was prone to occur during physical work. Hypertension was the most common preexisting disease, and its association was significantly high in patients younger than 70 years of age as compared to control patients. Hypertension was considered to be a risk factor of SAH, particularly for younger patients.