IN THE recent literature dealing with spontaneous subarachnoid hemorrhage and the surgical treatment of intracranial aneurysms, there is little or no recorded experience with the finding of associated subdural hematoma. That these two hemorrhagic processes may originate in a common bleeding episode has been recognized by Dott,1 Helpern,2 and Jaeger.3 Recognition of this possibility will suggest, in cases of subdural hematoma without evidence of traumatic origin, a search for well-known sources of subarachnoid bleeding. On the contrary, in cases of subarachnoid hemorrhage followed by certain unusual developments, the presence of a subdural hematoma may be suspected.
Of our series of 334 cases of proved subarachnoid hemorrhage of nontraumatic origin,4 a subdural hematoma was discovered in 13. In each case the age of the subdural hematoma, as judged by the degree of clot organization or membrane formation, corresponded with the time lapse after a definite bleeding episode.