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Sudden death from aneurysmal subarachnoid hemorrhage
W I Schievink1, E F Wijdicks, J E Parisi
1Department of Neurologic Surgery, Mayo Clinic, Rochester, MN 55905, USA.
Neurology
|May 1, 1995
Summary
Sudden death from aneurysmal subarachnoid hemorrhage (SAH) is often linked to posterior circulation aneurysms and intraventricular hemorrhage. This pattern remained consistent over three decades, despite medical advancements.
Area of Science:
- Neurology
- Epidemiology
- Pathology
Background:
- Aneurysmal subarachnoid hemorrhage (SAH) is a critical condition.
- Patients experiencing sudden death from SAH are often excluded from studies.
- Understanding the profile of sudden SAH deaths is crucial for public health.
Purpose of the Study:
- To investigate the clinical and pathological characteristics of sudden death in aneurysmal subarachnoid hemorrhage (SAH).
- To determine if the frequency of sudden SAH deaths has changed over time.
Main Methods:
- Retrospective review of aneurysmal SAH cases in Rochester, Minnesota (1960-1989).
- Identification of patients who died before reaching medical attention.
- Comparison of clinical and pathological features between sudden death and attended SAH cases.
Main Results:
- 12% of aneurysmal SAH patients died suddenly before medical attention.
- Sudden death cases were significantly associated with posterior circulation aneurysms (38% vs. 14%).
- Autopsy findings in sudden death cases included intraventricular hemorrhage (92%) and pulmonary edema (92%).
Conclusions:
- The incidence of sudden death from aneurysmal SAH remained stable over 30 years.
- Sudden death from aneurysmal SAH is characterized by posterior circulation aneurysms, intraventricular hemorrhage, and pulmonary edema.
- Intracerebral hemorrhage is rarely associated with sudden aneurysmal SAH death.