Prognosis in Spontaneous Subarachnoid Hemorrhage

IN A FORMER report,¹Richardson and I discussed in considerable detail the pathologic and clinical aspects of spontaneous subarachnoid hemorrhage due to berry aneurysms based on a study of 118 patients observed in the Toronto General Hospital from 1928 to 1938 inclusive. In a consideration of the prognosis, it was found that approximately 50 per cent of patients recover from the attack that brings them under observation. There was evidence that unconsciousness at the onset, preexisting hypertension and advanced age made the prognosis a little graver. It was found that when intracerebral bleeding occurs from ruptured aneurysm of the circle of Willis survival is rendered more uncertain. There was no evidence that a history of one or more preceding attacks made the prognosis any worse. Thirty-seven survivors were followed for an average of four years after their discharge from the hospital. It was found that the great majority were