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Most forms of cerebral hemorrhage occur in the later years of life or in persons whose cerebral blood vessels have been damaged by sclerosis, tumors or intercurrent infection. The condition commonly called spontaneous subarachnoid hemorrhage, however, appears frequently in youth and in early middle age and is usually difficult to associate with any precipitating influence. In this condition massive extravasation of blood into the subarachnoid space follows spontaneous rupture of a blood vessel. Hemorrhages into the same space resulting from extension of intracerebral bleeding, minor bleeding in the course of systemic infections, blood diseases or hemorrhages occurring during agonal episodes are excluded. The underlying causes of this condition are uncertain. Strauss and his co-workers1 state that the common anatomic changes are arteriosclerosis of the cerebral blood vessels with or without frank aneurysmal defects. Inflammatory lesions of the blood vessels, they say, may also cause formation of aneurysms with ultimate
SUBARACHNOID HEMORRHAGE. JAMA. 1943;123(15):972–973. doi:10.1001/jama.1943.02840500036013
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