The worst headache of his life, a sudden onset of severe headache accompanied by nausea, blurred vision, stiff neck and loss of consciousness, happened when he was simply at home doing daily activities. He had no symptoms before it happened and after he was taken to the hospital, he was diagnosed with aneurysmal subarachnoid hemorrhage. Cerebrovascular diseases, mainly stroke, are the second leading causes of death worldwide according to the WHO. Approximately 5% to 15% of stroke cases have aneurismal origin with a 30-day mortality rate of 45%. Among the survivors 30% has moderate-to-severe disabilities . No less than an estimated 2% of the population has an intracranial aneurysm but fortunately only a few of them rupture, with an annual estimated risk of 0.7% . Research shows that most aneurysms are small and 50% to 80% of them do not rupture during the course of a person’s life. Between 10% to 30% of the patients have multiple aneurysms.

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The research in this book was conducted at the Departments of Radiology and Medical Informatics of the Erasmus Medical Centre Rotterdam, the Netherlands. Additional financial support for publishing this thesis was kindly provided by the Department of Radiology of Erasmus MC Rotterdam, the Erasmus University Rotterdam and the ASCI graduate school.
W.J. Niessen (Wiro)
Erasmus University Rotterdam
ASCI dissertation series
Erasmus MC: University Medical Center Rotterdam