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Physicians have long been trained to consider aneurysmal subarachnoid hemorrhage (aSAH) as the potential cause of the worst headache of a patient's life. But subsequent treatment and the expected outcomes have markedly changed. To assess how aSAH outcomes have changed in the past few decades, the Oxford group meticulously analyzed both their local epidemiologic data (using the overlap of patients who were in both the Oxford Community Stroke Project in 1981–1984 and 1986 and the Oxford Vascular Study in 2002–2008) and published data on aSAH worldwide.
The group found that since the 1980s, aSAH incidence has not changed much (although strokes have decreased overall), but imaging is more intensive and aneurysm obliteration is done much sooner. …