Family history of subarachnoid haemorrhage

Case report

Female, hypertensive, smoker with a family history of subarachnoid haemorrhage: A high risk combination

The major risk factors for subarachnoid haemorrhage are increasing age, female gender, smoking and hypertension. The case is presented of a young woman with these risk factors in addition to a positive family history.

History:

A 31 year old lady was admitted with Subarachnpod haemorrhage; 2 months after her mother had been treated in the same unit for a ruptured middle cerebral artery aneurysm. She is a smoker and an hypertensive.

Images of the daughter:

   

   

Images of the mother:

  

Discussion:

The major risk factors for SAH are the female gender, smoking and hypertension. Most patients with SAH are female and <60 years of age (reported peak age for SAH in many parts of the world is between 40-60 years). The avoidance of risk factors for aneurysms such as smoking, hypertension and hypercholesterolaemia should be part of the management of at-risk subjects. First-degree relatives of patients with SAH, also have an increased risk compared with the general population. Evaluation for unruptured aneurysms in high risk patients and early surgical management is probably worthwhile in suitable candidates according to the results of the International study of unruptured intracranial aneurysms (ISUIA). The results of surgical or endovascular management of unruptured aneurysms are very good though patients must be counselled adequately.

 

Created by B I Ogungbo in September 2002. Modified January 2008. ©