Despite characteristic and striking clinical symptoms and a not infrequent occurrence, the syndrome of spontaneous subarachnoid hemorrhage is still largely unrecognized in general practice. This fact, together with the recent observation of a case of spontaneous subarachnoid hemorrhage, has prompted a brief review of the present status of the subject and a report of the case at hand.
Subarachnoid hemorrhage, like jaundice or pruritus, is merely a symptomatic expression of some more fundamental pathologic state. Subarachnoid hemorrhage as a coincidental sign may be found in a variety of pathologic conditions. It may occur in trauma directed to the skull or vertebral column, as in fracture or dislocation, when vessels are ruptured and blood is extravasated into the subarachnoid space. It may occur in acute or chronic inflammatory processes in the meninges or encephalon, as in meningococcic, syphilitic or tuberculous meningitides or in epidemic and hemorrhagic encephalitides (vaccinia, smallpox and measles).