Which site is more common for sah

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The textbooks give a clear, consistent answer. Here is a complete summary:

Most Common Site for SAH (Subarachnoid Hemorrhage)

About 80% of spontaneous SAH cases are caused by rupture of a saccular (berry) aneurysm. These aneurysms form at arterial branch points, and their distribution by frequency is:
RankLocationApproximate Frequency
1stAnterior communicating artery (AComA)~30%
2ndPosterior communicating artery (PComA)~25%
3rdMiddle cerebral artery (MCA) bifurcation~20%
OtherRemaining vessels (basilar, vertebral, etc.)~25%
Key points:
  • Over 85% of aneurysms arise from the anterior (carotid) circulation; only ~10% come from the vertebrobasilar system.
  • Berry aneurysms are most often found at bifurcation points of the middle cerebral, anterior cerebral/AComA, and posterior communicating arteries.
  • They are least common at the vertebral artery.
  • Certain conditions increase risk: autosomal dominant polycystic kidney disease and Ehlers-Danlos syndrome type IV.
So, in short: the anterior communicating artery is the single most common site for a ruptured aneurysm causing SAH (~30% of cases).
  • Neuroanatomy through Clinical Cases, 3rd Ed.
  • Goldman-Cecil Medicine, International Ed.
  • Essentials of Forensic Medicine and Toxicology, 36th Ed.
  • Grainger & Allison's Diagnostic Radiology
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