The rupture of a brain aneurysm is a relatively rare event but, as it causes bleeding in the brain, that event is a potentially devastating one. Now researchers have attempted to identify possible triggers for such ruptures, also known as hemorrhagic strokes, finding that sex, coffee and losing one’s temper -- among other things -- may raise the risk.

Such ruptures begin with aneurysms, which are weak spots in blood vessels in the brain. Under stress, those weak spots can rupture and lead to hemorrhaging, or bleeding. But it wasn’t clear what activities put people at the most risk of a resulting hemorrhagic stroke.

In surveying 250 people who’d recently had a subarachnoid hemorrhage resulting from an aneurysm, researchers in the Netherlands asked how often in the past year, and just before the hemorrhage, they were exposed to 30 potential triggers, such as smoking, drinking alcohol and having sex.

By assessing the frequency and intensity of their exposure to such triggers, researchers found that eight activities appeared to make a rupture more likely:

-Drinking coffee

-Drinking soda

-Blowing your nose

-Straining on the toilet

-Being startled

-Getting angry

-Having sex

-Exercising

The common factor? All produced sudden, short increases in blood pressure.

That doesn’t mean people with aneurysms should try to cut out all those activities—though it couldn’t hurt to get rid of, for example, anger issues. The researchers wrote:

“Reducing caffeine consumption or treating constipated patients with unruptured [intracranial aneurysms] with laxatives may lower the risk of [subarachnoid hemorrhage]. Although physical exercise has a triggering potential, we do not advise refraining from physical exercise because it is also an important factor in lowering the risk of other cardiovascular diseases.”

The results were published online Thursday in Stroke.

About 2% of people have aneurysms, the authors point out, but most never rupture. In the U.S., there are 25,000 to 27,000 ruptures per year; about 40% are fatal, according to the Brain Aneurysm Foundation.

healthkey@tribune.com

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