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NEUROLOGY 1993;43:712
© 1993 American Academy of Neurology

Clinical course of spontaneous subarachnoid hemorrhage

A population-based study in King County, Washington

W. T. Longstreth, Jr., MD, MPH, Lorene M. Nelson, PhD, Thomas D. Koepsell, MD, MPH and Gerald van Belle, PhD

Neuroepidemiology Group at the University of Washington, including the Division of Neurology, Department of Medicine, School of Medicine, and the Departments of Epidemiology, Health Services, Environmental Health, and Biostatistics, School of Public Health and Community Medicine, University of Washington, Seattle, WA.

Over 2 years, we identified 171 patients in King County, Washington, experiencing an incident subarachnoid hemorrhage and characterized their clinical course and outcome. Most (65%) were women and most (68%) were under age sixty-five. Only five died without medical attention. The remaining 166 patients were hospitalized and had CTs of the head. Of these, 103 underwent aneurysm surgery, 40 developed acute hydrocephalus, 32 had symptomatic vasospasm, and 30 re-bled. Sixty-eight percent (68%) survived to 1 month after the bleed and 62% to 1 year. Independent predictors of good recovery by 1 month after the bleed included youth, a high score on the admission Glasgow Coma Scale, and absence of blood on the first CT. In this population-based series, at 1 month after the bleed, approximately one-third of patients were dead, one-third had neurologic deficits, and one-third were doing well.

Presented in part at the 43rd annual meeting of the American Academy of Neurology, Boston, MA, April 1991.

Address correspondence and reprint requests to Dr. W.T. Longstreth, Jr., Division of Neurology, ZA-95, Harborview Medical Center, 325 Ninth Avenue, Seattle, WA 98104-2499

Supported by a grant from the National Institute of Neurologic Diseases and Stroke (RO1 NS22690).

Received June 19, 1992. Accepted for publication in final form August 18, 1992.




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