Stress-Induced Subarachnoid Hemorrhage: A Case Report

While there are many forms of intracranial hemorrhage (ICH), the most common form affecting young to middle-aged patients is subarachnoid hemorrhage (SAH). SAHs are primarily traumatic, while a minority of cases are spontaneous. The majority of spontaneous SAHs occur due to the rupture of a cerebrovascular aneurysm. A small number of spontaneous SAHs occur without any objective findings of an aneurysm. Most of these cases are in older patients with certain risk factors such as smoking, hypertension, and alcohol use. This article reports a young female patient without any known significant risk factors who developed an acute spontaneous SAH while experiencing a significant psychological stressor. Recent literature has focused on certain somatic manifestations of psychological stressors, such as stress-induced (Takotsubo) cardiomyopathy. We postulate that our patient's SAH was a sequela of psychological stress and that the pathophysiology may be similar to Takotsubo cardiomyopathy.