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How are patients graded following subarachnoid hemorrhage from a ruptured aneurysm?
The incidence of subarachnoid hemorrhage is about 10–15 per 100,000 person-years. Angiography shows an intracranial aneurysm as the cause of subarachnoid hemorrhage in 80–85% of patients. Cerebral aneurysms are most often found at bifurcations near the circle of Willis, and the risk of rupture is increased with increasing size. Subarachnoid hemorrhage almost always presents with rapid onset of severe headache. The presence of other signs and symptoms is used to clinically grade these patients. The Hunt–Hess Clinical Grade classification is most widely used (Table 18.1).
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