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Aneurysmal Subarachnoid Haemorrhage: Epidemiology, Aetiology, and Pathophysiology

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Management of Subarachnoid Hemorrhage

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Abstract

Spontaneous subarachnoid haemorrhage in the majority of patients is due to the rupture of cerebral aneurysms. There is a decreasing trend in the incidence of aSAH (aneurysmal subarachnoid haemorrhage). The current global incidence is 6.1/100,000 population. There are various modifiable risk factors such as hypertension, smoking, alcohol abuse, dyscholesterolemia, recreational drug abuse, and low body mass index. The non-modifiable risk factors for aSAH are gender, familial, and connective tissue disorders.

Among the risk factors associated with the pathophysiology of cerebral aneurysm formation; increasing hemodynamic stress on the vessel walls which is considered as one of the most important risk factors. It leads to remodelling of and a decrease in collagen strength, which bulge out and form an aneurysm. The continuous stress on the vessel with an aneurysm causes rupture at the weaker part of the aneurysm. Rupture of the cerebral aneurysm has immediate effects due to spreading blood in the subarachnoid space, pressure effect due to hematoma formation, and catecholamine storm. Spreading of blood in subarachnoid space may damage the blood–brain barrier (BBB), causing cerebral oedema and cerebral vasospasms. If cerebral vasospasm develops in the delayed phase, it may cause cerebral ischaemia, and persistent blood in the subarachnoid and ventricular space may cause late hydrocephalus. The catecholamine surge causes systemic complications like cardiopulmonary, renal, and other organ dysfunction.. This chapter describes epidemiology, aetiology, and pathophysiology of aneurysmal subarachnoid haemorrhage.

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Authors and Affiliations

  1. Department of Anesthesia, Perioperative Medicine and Critical Care, Hamad Medical Corporation, Doha, Qatar

    Nissar Shaikh, Arshad Chanda, Shoaib Nawaz, Adel E. Ahmed Ganaw & Mohammad Faisal Malmstrom

  2. Surgical Intensive Care Unit, Hamad Medical Corporation, Doha, Qatar

    Nissar Shaikh

  3. Department of Neurosciences, Neurosurgery Section, Hamad Medical Corporation, Doha, Qatar

    Alisha Alkubaisi & Abdulnasser Alyafei

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  1. Nissar Shaikh
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  2. Arshad Chanda
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  3. Shoaib Nawaz
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  5. Abdulnasser Alyafei
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  6. Adel E. Ahmed Ganaw
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  7. Mohammad Faisal Malmstrom
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Correspondence to Nissar Shaikh .

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Editors and Affiliations

  1. Anesthesia, Perioperative Medicine and Critical Care Department, Hamad General Hospital Hamad Medical Corporation, Doha, Qatar

    Adel E. Ahmed Ganaw

  2. Department of Anesthesia Perioperative Medicine and Critical Care, Surgical Intensive Care Unit Hamad Medical Corporation, Doha, Qatar

    Nissar Shaikh

  3. Faculty of Medicine, Tanta University, Tanta, Egypt

    Nabil A. Shallik

  4. Department of Anesthesiology, University of Muenster, Muenster, Germany

    Marco Abraham E. Marcus

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Shaikh, N. et al. (2022). Aneurysmal Subarachnoid Haemorrhage: Epidemiology, Aetiology, and Pathophysiology. In: Ganaw, A.E.A., Shaikh, N., Shallik, N.A., Marcus, M.A.E. (eds) Management of Subarachnoid Hemorrhage. Springer, Cham. https://doi.org/10.1007/978-3-030-81333-8_1

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  • DOI: https://doi.org/10.1007/978-3-030-81333-8_1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-81332-1

  • Online ISBN: 978-3-030-81333-8

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