Peter Hibberd, M.D., is a doctor whose advice is based on more than 28 years of hospital outpatient and inpatient experience. He is an experienced emergency medicine physician, surgeon, and consultant. Dr. Hibberd is certified by the American Board of Emergency Medicine. He is also a fellow and active member of the American Academy of Family Physicians, an active member of the American College of Emergency Physicians, and a member and fellow of the American Academy of Emergency Medicine. Dr. Hibberd has earned numerous national and international professional certifications, memberships, and awards.
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Repeat Subarachnoid Hemorrhage?

Friday, 09 Jul 2010 11:03 AM


Question: I had a subarachnoid hemorrhage two years ago, and the doctors were unable to find a cause. What are the chances that this could happen again?

Dr. Hibberd's Answer:

Subarachnoid hemorrhage (SAH) in the absence of infection or trauma is very important to investigate completely. Half of SAH victims die and 10 to 15 percent never reach the hospital. A SAH is regarded as a form of stroke, and accounts for 1 to 7 percent of all strokes. Until proven otherwise, it is assumed that you have a micro-aneurism or arteriovenous malformation. If none is discovered by appropriate imaging, close follow-up and periodic re-evaluation is mandatory.

It is not unusual for the first angiogram to be negative only to find the offending lesion on repeated examinations. Remember, imaging is only a snapshot in time, and not always perfect. You would be wise to maintain low normal blood pressures, avoid overly physical occupations and have a consultation and re-evaluation at a neurosurgical center. Cocaine abuse and sickle cell disorders along with coagulation and bleeding disorders are associated with spontaneous SAH. Until the cause is discovered, your risk of recurrence is unknown!



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