Introduction

Subarachnoid hemorrhage (SAH) is a serious pathology, associated with 43% mortality and significant disability. In the absence of relevant guidelines, some teams advocate that patients harboring an unruptured intracranial aneurysm (ICA) abstain from all sports activity, as a prophylactic precaution. The aim of the present study was to evaluate the impact of physical activity as a risk factor for SAH, through a review of the literature.

Method

A systematic literature review was performed for the period 2000 to 2020 in accordance with the PRISMA guidelines. Prospective and retrospective articles reporting more than 50 patients whose physical activity was associated with onset of SAH were included. The main end-point was prevalence of SAH occurring after physical activity. For comparison purposes, the prevalences of other circumstances were calculated to establish a range of frequency.

Results

Physical activity appeared to be quite rarely associated with onset of SAH, with a prevalence of 3%, compared to 30% at rest, 7.3% in association with defecation and 4.5% in association with sexual activity. Age under 60 years, male gender (M/F ratio 1.38) and smoking (67.1%) were associated with onset of SAH during physical activity.

Conclusion

Physical activity appears to be a rare trigger factor for SAH. These results are in contrast to the idea that physical activity should, as a precaution, be avoided in patients with unruptured ICA. There is at present no scientific evidence of an association with aneurysmal SAH.

中文翻译：

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体力活动是蛛网膜下腔出血的触发因素吗？

介绍

蛛网膜下腔出血 (SAH) 是一种严重的病理，与 43% 的死亡率和严重的残疾有关。在没有相关指南的情况下，一些团队提倡患有未破裂颅内动脉瘤 (ICA) 的患者放弃所有体育活动，作为预防措施。本研究的目的是通过文献回顾评估体育活动作为 SAH 危险因素的影响。

方法

根据 PRISMA 指南，对 2000 年至 2020 年期间进行了系统的文献回顾。前瞻性和回顾性文章报告了 50 多名体育活动与 SAH 发病相关的患者。主要终点是体育活动后发生的 SAH 患病率。为了比较的目的，计算了其他情况的发生率以确定频率范围。

结果

体力活动似乎很少与 SAH 的发病相关，患病率为 3%，而休息时为 30%，与排便相关为 7.3%，与性活动相关为 4.5%。年龄在 60 岁以下、男性（M/F 比 1.38）和吸烟（67.1%）与体育活动期间 SAH 的发病有关。

结论

身体活动似乎是 SAH 的罕见触发因素。这些结果与未破裂 ICA 患者应避免身体活动作为预防措施的观点形成对比。目前没有科学证据表明与动脉瘤性 SAH 相关。