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<< An Evidence-Based Approach To Diagnosis And Management Of Subarachnoid Hemorrhage In The Emergency Department (Stroke CME)

Etiology And Pathophysiology

The international incidence of SAH varies significantly according to geographic region, ranging from 2 to 27 cases per 100,000 people per year, with an international aggregate of approximately 10 per 100,000 people per year, which is close to the United States incidence.13-15 Modifiable risk factors include cigarette smoking, hypertension, heavy alcohol use, cocaine abuse, caffeine use, and smokeless nicotine uptake; only hypertension and smoking are covered extensively in the literature.16-19 Nonmodifiable causes include family history of aSAH in a firstdegree relative, genetic disorders (eg, autosomal dominant polycystic kidney, sickle cell disease, Ehlers-Danlos syndrome, and Alpha-1-antitrypsin), and female sex.3,20-22 The risk posed by female sex varies according to parity, age of menarche, and menopause. Women who are primiparous, menopausal, or who began menstruation early have been found to have a higher risk of aSAH.3,23-26

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