title: Circumstances, activities, and events precipitating aneurysmal subarachnoid hemorrhage.
abstract: Medical records of 513 patients with aneurysmal subarachnoid hemorrhage were reviewed to analyze the factors precipitating aneurysmal rupture. There was no seasonal difference in incidence. A significantly higher incidence was observed during 6:00 AM to 9:00 AM and 6:00 PM to 9:00 PM when engaging in daily routines such as defecation/micturition, brushing teeth/washing face/dressing, eating/drinking, and taking a bath. These activities are associated with a Valsalva maneuver that results in sudden pressure changes across the aneurysmal wall precipitating aneurysmal rupture. Aneurysmal rupture occurred most frequently during talking, chatting, watching television, or staying home without any strenuous physical activity. Considering the time spent, the highest incidence rate was found during defecation/micturition. There was no significant difference between men and women or between younger and older age groups regarding activities or events preceding aneurysmal rupture. Hypertension was the most common pre-existing medical problem. The main results are the same as those of the previous study except for aging of the patients.
authors: Department of Neurosurgery, Shiga University of Medical Science, Ohtsu, Japan.
authors: Masayuki
authors: M
authors: Matsuda
authors: Kazuyoshi
authors: K
authors: Watanabe
authors: Akira
authors: A
authors: Saito
authors: Ken-Ichi
authors: K
authors: Matsumura
authors: Masaharu
authors: M
authors: Ichikawa
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000150:complications*; D001794:Blood Pressure; D003672:Defecation; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology; D015994:Incidence; D002532:Intracranial Aneurysm / Q000150:complications*; D007899:Leisure Activities; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012422:Rupture, Spontaneous; D013345:Subarachnoid Hemorrhage / Q000453:epidemiology* / Q000209:etiology; D013997:Time Factors; D014554:Urination; D014636:Valsalva Maneuver