Warning signs prior to rupture of an intracranial aneurysm

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  • 1 Division of Neurosurgery, University of Iowa, College of Medicine, Iowa City, Iowa
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✓ Warning signs prior to major hemorrhage were analyzed in 112 cases of single intracranial aneurysm. Fifty-four of 112 patients (48.2%) showed such signs, and the incidence for women was slightly higher (49.2%) than that for men (46.6%). Incidence decreased as patient age advanced, more steeply for men than women. Incidence and characteristics of warning signs varied according to location of aneurysm. Nineteen different signs occurred in 97 instances for 54 patients (average 1.76), and were placed into three groups according to possible etiologies: Group 1, vascular origin due to expansion of aneurysm and adjacent artery; Group 2, minor bleeding; and Group 3, ischemic lesion, arterial spasm, or occlusion. The average time interval from onset of warning sign to major hemorrhage was 20.7 days: 110.5 days for Group 1, 10.4 days for Group 2, and 21.0 days for Group 3. Therefore, signs in Group 2 suggest the necessity of most urgent medical attention. Results of treatment clearly suggested the group with warning signs fared better than the others. Possible reasons for this are discussed.

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Contributor Notes

Address reprint requests to: Shige Okawara, M.D., Division of Neurosurgery, University of Iowa, College of Medicine, Iowa City, Iowa.
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