Multiple authors have identified the most unusual novel associations as precipitant factors of subarachnoid hemorrhage and the knowledge of these and pathogenesis in background is necessary to suspect and therefore timely diagnose subarachnoid bleed and understand the mechanism of its subsequent complications. Objective: We herein describe unusual causes of subarachnoid bleed reported in various case reports with a comprehensive but elaborative review describing underlying pathogenesis and physiological mechanisms behind these precipitants and complications. Evidence Review: We sorted unusual causes of subarachnoid hemorrhage from literature review. By conducting meticulous scrutinization on search engines likePubmed®, Medline ®, Medline Plus ®, PubMed Central ®, MedNets®, Medbioworld®, Journal Watch® and Pakmedinet®; we found many novel associations using the key words: “Hemorrhagic stroke; subarachnoid hemorrhage; unusual precipitants; novel causes; pathogenesis; physical principles; aneurysms”. Findings: Novel associations of subarachnoid bleed include coagulopathies, lumbar puncture, degenerative vascular diseases, herpes encephalitis, sexual intercourse, bee sting, Conn’s syndrome and likewise many others. The basis of pathogenesis and its complications lies in understanding the complexity of relationship between the dynamics of intracranial pressure, volume and flow. Conclusions and Relevance: Understanding the physiology of exchange of force between different intracranial contents is the key to learn the mechanics of complicated brain injuries in SAH. Identifying the most unusual novel associations as precipitant factors of subarachnoid hemorrhage and the knowledge of these and the pathogenesis behind complications is necessary to suspect and therefore timely diagnose subarachnoid bleed.It may also help generate newer ideas for management in SAH.
Nomani, Ali Zohair and Nabi, Sumaira
"Subarachnoid hemorrhage:unusual situations leading to sah and underlying principles of physics behind its complications,"
Pakistan Journal of Neurological Sciences (PJNS): Vol. 11
, Article 1.
Available at: http://ecommons.aku.edu/pjns/vol11/iss3/1