The incidence of subarachnoid haemorrhage is about 10:100000 per year in Western Europe and USA and comprises some 10% of all cases of cerebrovascular disease. Forty five per cent of patients die within the first 30 days following subarachnoid haemorrhage; nearly two thirds die as a result of the initial haemorrhage and most within the first two days. Despite vigorous therapeutic efforts, the mortality rate from subarachnoid haemorrhage remains high. A greater understanding of the basic mechanisms and pathology of subarachnoid haemorrhage may lead to more effective prevention and therapeutic strategies. This leader reviews the causes and results of subarachnoid haemorrhage and examines how myths surrounding subarachnoid haemorrhage and saccular aneurysms have been dispelled by the introduction of new techniques and more reliable clinical and epidemiological data.
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