Q: Vasospasm usually occurs after day 3 in subarachnoid haemorrhage (SAH). What is the main risk factor of vasospasm happening within first 3 days of SAH?

 A) Severe SAH 
B) Female gender
C) Young  age 
D) Smoking
E) Prior SAH


Answer: E

It is true that all of the above increase the risk of vasospasm in SAH, but it usually occurs from day 3 to day 21, peaks around day 7 and risk subsequently decreases after day 12-14. But with patients who have prior SAH (may have gone unnoticed), there is a high risk of vasospasm happening before day 3.


Further reading:

1. E. Sander Connolly, Alejandro A. Rabinstein, J. Ricardo Carhuapoma, Colin P. Derdeyn, Jacques Dion, Randall T. Higashida, Brian L. Hoh, Catherine J. Kirkness, Andrew M. Naidech, Christopher S. Ogilvy, Aman B. Patel, B. Gregory Thompson, Paul Vespa - Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association - Stroke. 2012;43:1711-1737,  Originally published May 25, 2012 - http://stroke.ahajournals.org/content/43/6/1711