Subarachnoid hemorrhage (SAH) refers to bleeding within the subarachnoid
space, which is the area between the brain and the tissues that cover the
brain.
The subarachnoid space is the space through which the cerebrospinal
fluid circulates and it is responsible for protecting the brain from serious
injuries by serving a sort of cushion. When a hemorrhage occurs in this space,
a person may experience coma, paralysis, and even death.
This condition can occur rapidly, and the key to survival is immediate
medical intervention. If you or someone you know are experiencing the symptoms
of SAH, call a doctor or emergency health professional as soon as possible.
Symptoms of SAH
The main symptom is a severe headache, which is more intense at the base
of the skull. Some patients may even feel a popping sensation in the head
before the hemorrhage begins.
You may also experience:
- neck
pain
- numbness
throughout your body
- shoulder
pain
- seizures
- confusion
- irritability
- sensitivity
to light
- decreased
vision
- nausea
- vomiting
- rapid loss of alertness
- Symptoms of SAH come on suddenly and you may lose consciousness quickly. If you experience any of these symptoms combined with a severe headache, it is important to seek emergency medical attention right away.
Causes of SAH
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Other causes of SAH include:
- bleeding
from an arteriovenous malformation (AVM)
- bleeding
disorders
- use of blood thinners
- A serious head injury—such as occurs in a car crash or when an older person falls and hits their head—can also lead to an SAH.
Risk Factors
SAH can occur at any age, and some people are even born with cerebral
aneurysms that can lead to this condition.
If you have aneurysms, it is important to see your doctor regularly to
help detect the potential for hemorrhaging before SAH develops.
Diagnosing SAH
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First, your doctor may conduct a computed tomography (CT) scan of the
head to detect bleeding in the skull. If the results are inconclusive, the
doctor may use a contrast dye during the procedure.
Other tests include:
- magnetic
resonance imaging (MRI) scan, using radio waves to get clear detailed
images of the brain
- cerebral
angiography—an exam that uses a X-ray and injected dye to detect blood
flow in the brain
- transcranial
ultrasound to detect blood flow in the arteries within the brain.
Treating SAH
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In order clip the aneurysm, a craniotomy (opening the skull to expose
the area of involvement) is performed and the aneurysm is closed. A technique
called endovascular coiling may also be used to reduce the risk of further
bleeding.
If SAH causes a coma, treatment will include appropriate life support
with artificial ventilation, protection of the airways, and placement of a
draining tube in the brain to relieve pressure.
If you don’t lose consciousness as part of SAH, you will still be given
strict instructions to prevent post-treatment coma. Bed rest is standard for
patients recovering from this condition. You will also be instructed to refrain
from straining your body or bending over because these actions can increase
pressure on the brain.
Your doctor may prescribe medications also.
Preventing SAH
The only way to prevent this condition is to identify potential problems
within the brain. Early detection and, in some cases, treatment of a brain
aneurysm can prevent a subsequent hemorrhage in the subarachnoid space.
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