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Losing your temper, having sex or even blowing you nose could trigger a stroke if there is a vulnerable spot in one of the blood vessels surrounding your brain.

An estimated 2 per cent of the adult population has an intracranial aneurysm, in which a weak spot in a blood vessel wall bulges out like a balloon. If it ruptures, it can result in a subarachnoid hemorrhage, or bleeding in the area between the brain and the thin tissues that cover the vital organ.

Any activity that temporarily increases blood pressure can cause the vessel to suddenly burst.

Dutch researchers have identified eight leading triggers and ranked them according to the likelihood of making an aneurysm go pop.

For instance, drinking coffee raises blood pressure slightly, and increases the odds of having one of these strokes by 1.7 times for about an hour, said the lead researcher, Monique Vlak, of the University Medical Center in Utrecht.

Getting angry, she added, can cause blood pressure to skyrocket and temporarily boost the stroke risk 6.3 times, compared to when the person has a calmer disposition.

As part of their study, the researchers recruited 250 patients who recently suffered from one of these brain bleeds. The patients, or their close relations, were quizzed about the activities performed shortly before the stroke occurred. Based on the responses, the researchers produced a list of the most common triggers.

In many respects, coffee elevates the risk by a relatively small amount, compared to losing your temper. But because people tend to drink coffee on a regular basis, it ended up leading the list, said Dr. Vlak. Most people, she noted, don't blow their top daily.

According to findings published in the journal Stroke, the researchers estimated:

  • Drinking coffee was linked to 10.6 per cent of the subarachnoid-hemorrhages in the study group.
  • Vigorous physical exercise: 7.9 per cent
  • Nose blowing: 5.4 per cent
  • Sexual intercourse: 4.3 per cent
  • Straining to defecate: 3.6 per cent
  • Cola consumption: 3.5 per cent
  • Being startled: 2.7 per cent
  • Being angry: 1.3 per cent

So what do you do with such a list? In practical terms, not much unless you know you have an unruptured aneurysm in your brain. However, most cases go undetected until the individual suffers a stroke. Fortunately, this condition is relatively rare and represents only a small fraction of all strokes - most of which are caused by clots, or blockages, in the blood vessels of the brain.