bobby
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what is the MCC of subarachnoid hemorrage?
trauma
ruptured berry aneurisma
AV malformation
i have seen somewhere that it is trauma, what do u think?
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| phuluong2k
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i think trauma too
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| sumie
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i think trauma too
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| chemamr
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itīs trauma. Doubtless.
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| bobby
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seems as some authors claims it to be ruptured berry aneurism (kaplan)
i am kind of confused between trauma and ruptured ba
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| chemamr
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no way, the most common cause of SAH is trauma. The most common cause of non traumatic SAH is ruptured berry aneurysm.
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| tamar
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| chemamr
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why that , itīs very clear.
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| aliakram
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as u get more trauma these days then ppl with berry  ( incidence goes into 1 in thousands approx) and we all know how much trauma is common, any1 watchin ER will second this hehhe
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| ARJ
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Why to worry USMLE stopped asking question like which is the most common cause ?
Its in the form of vignette and not in a single line.
Edited by ARJ on 09/19/05 - 07:53 AM
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| merrk
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Really? that's good news!
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| adeelmd
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kaplan 2005 notes intermal medicine page 103... It's a ruptured aneurism... trauma is RARE cause of sah.... I also remember Goljian saying that the most common cause of an aneurism in the brain is htn.... thus htn--->anuerism---->sah... but Fisher says that most commonly sah occurs spontaneously.... It is definitely very common in pkd and e-d.... (by default marfan's is also a connective tissue disorder, so it should be common in that disease as well)
USMLE doesn't ask what is the most common cause... but it asks you common things.... For example, if you don't know the answer, pick the most common thing.. and you wil be right most of the time; problem is uw and kaplan are the exact opposite of this strategy- pick the weirdest answer and you will be right.
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| phuluong2k
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You are great
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| ARJ
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thats a great answer
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| nisha
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I think we should go by the most current and accurate info. but in the end it's ur choice.
Toronto Notes, (2005)
SAH eitiology
- trauma (most common)
- spontaneous-> aneurysms (75-80%)
- -> idiopathic (14-22%)
- -> AVM's (5%)
- coagulopathies (iatrogenic or primary, vasculitides, tumors (<5%
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| drkpp
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hey nisha i dont et it even now. if aneurysm iss 70% implies its the most common!!! isnt it?
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| adeelmd
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always trust Kaplan notes. No matter what any other book says really. that's because Kaplan is explicitely written for the usmle, and other texts don't really care what the right answer would be in the boards. Of course, if it's a glaring well documented issue that is in many books; then I would go against kaplan... but if you don't trust the notes then what can you trust?
Think of this way, it is very hard to rupture a vessel in any trauma, unless they are superficial (mma and bridging)... it's nearly impossible to rupture deep lying vessels... for a patient to get sah he would first have to get through an epidural hematoma, then a subdural one, then get cerbral contusions... possible even diffuse axonal injury before he could rupture anything in the circle of willis.
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| nisha
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I guess the bottom line is read the vignette in the test, if it's similar to the UW question on this topic(don't remember exact question) then we pick trauma as the most common answer. But if the person gets a sever headache while carrying out their routine activity, we know it's rupture of an anuerysm...........
drkpp-> its like chemamr said, rupture of berry aneurysm is the most common cause of non traumatic SAH
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| drkpp
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| bobby
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nisha wrote:I think we should go by the most current and accurate info. but in the end it's ur choice. Toronto Notes, (2005) SAH eitiology - trauma (most common) spontaneous-> aneurysms (75-80%) -> idiopathic (14-22%) -> AVM's (5%) coagulopathies (iatrogenic or primary, vasculitides, tumors (<5%
what a confusing statistics......
if aneurysma is /5-80%, isn't it the most common overall? why write trauma as the most common?
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| nisha
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In general, trauma is the most common cause of SAH, the next most common cause of SAH is spontaneous rupture. Under the category of spontaneous rupture fall: aneurysms, idiopathic and AV malformations. I was trying to show by the arrows distribution of eitiology of a spontanous SAH.
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