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For further information, see CMDT Part 24-09: Stroke

Key Features

Essentials of Diagnosis

  • Sudden ("thunderclap") severe headache

  • Signs of meningeal irritation usually present

  • Obtundation is common

  • Focal deficits frequently absent

General Considerations

  • 5–10% of strokes are due to subarachnoid hemorrhage

  • Trauma is the most common cause

  • Frequently results from the rupture of an arterial saccular ("berry") aneurysm or from an arteriovenous malformation

  • Factors associated with a higher risk of subarachnoid hemorrhage

    • Older age

    • Female sex

    • "Non-white" ethnicity

    • Hypertension

    • Tobacco smoking

    • High alcohol consumption (exceeding 150 g per week)

    • Previous symptoms

    • Posterior circulation aneurysms

    • Larger aneurysms

  • See also Aneurysm, Intracranial

  • See Table 24–3

Table 24–3.Features of the major stroke subtypes.

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