The syndrome of subarachnoid hemorrhage from ruptured intracranial aneurysm is well known. The symptoms vary; in some the symptoms are severe and progressive, in others the course may fluctuate. This fluctuation may be very conspicuous, so that after several days of relative improvement with lucidity there appears an increasing drowsiness or stupor. In these instances, one may conclude that there has been a recurrence of the intracranial bleeding, as confirmed by the reappearance or increase in the amount of blood in the cerebrospinal fluid. The downhill course, however, may be due to aneurysmal bleeding into the substance of the brain or into the subdural space. According to Logue 9 and Clarke and Walton,3 hemorrhage from a ruptured aneurysm frequently extends into the subdural space. These extensions are small, form a very thin layer over the brain, and are usually found at autopsy. There are cases in which the subdural
BORNSTEIN MB, BENDER MB. Subarachnoid Hematoma Complicating Ruptured Intracranial Arterial Aneurysm. AMA Arch Intern Med. 1957;100(1):50–58. doi:10.1001/archinte.1957.00260070064006
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