SUZANNE CALLANDER reports on the findings and principal recommendations of a recent National Confidential Enquiry into Patient Outcome and Death (NCEPOD) report that looks at the pathways for all patients diagnosed with an aneurysmal subarachnoid haemorrhage.
Subarachnoid haemorrhage (SAH) is a devastating condition which is often caused by the rupture of a cerebral aneurysm (aSAH). SAHs account for about 5% of all cerebrovascular events in the UK,1 with 85% of SAHs being a result of aneurysm.2, 3
Autopsy studies have shown that between 3.6% and 6% of the population have unruptured intracranial aneurysms. There is an increased rate of aSAH in first degree relatives of aSAH patients and the risk of rupture increases with age and is greater in women. It is also more common in patients with connective tissue disorders or polycystic kidney disease. Hypertension and smoking are also significant risk factors for aneurysmal rupture.4
Outcome is generally poor, with up to 10% of aSAH patients not making it to hospital and 50% not surviving beyond one month from onset. Of those who survive the first month, 50% will remain dependent for help with activities of daily living. So, only 25% of patients can expect to return to a relatively normal life.5
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