Subarachnoid hemorrhage

A brain hemorrhage can occur anywhere on the outside and inside of the brain. A subarachnoid hemorrhage (SAH) is a type of hemorrhage that occurs between the brain and the membrane that protects it. It’s potentially life-threatening.

If you suspect you have a subarachnoid hemorrhage, call 911 immediately or get to your nearest emergency department.

The most common risk factor of a subarachnoid hemorrhage is a brain aneurysm, which is a balloon in your blood vessel that eventually bursts.

Other underlying risk factors of a subarachnoid hemorrhage include:

• Arteriovenous malformations (AVMs): Tangled webs of blood vessels, prone to leaks.
• Traumatic brain injury: A physical blow can damage brain tissues and blood vessels.
• High blood pressure: A constant strain on your arteries, increasing rupture risk.
• Blood thinners: While beneficial for some people, they can exacerbate bleeds if not carefully monitored. Let your doctor know if you are taking blood thinner medications.

In some cases, there may not be an underlying cause of a subarachnoid hemorrhage.

Symptoms of a subarachnoid hemorrhage

The most common symptom of a subarachnoid hemorrhage is a sudden, severe headache. Other symptoms may include:

• Nausea and vomiting
• Neck stiffness and pain
• Confusion, drowsiness or seizures
• Vision problems
• Fainting or loss of consciousness
• Weakness or paralysis
• Seizures

Recognizing the symptoms of a subarachnoid hemorrhage and getting prompt treatment is the key to improving recovery outcomes.

Diagnosing a subarachnoid hemorrhage

To make a subarachnoid hemorrhage diagnosis, your doctor will first ask about your symptoms and review your medical history.

Next, your doctor will work to locate the source of the bleeding by using imaging testing such as a CT scan or an MRI. They may also order one of the following advanced diagnostic tests for a subarachnoid hemorrhage:

• A lumbar puncture: Also known as a spinal tap, a lumbar puncture is another way to make a brain bleed diagnosis.
• Computed tomography angiography (CTA): During a CTA test, dye is injected directly into the bloodstream. This dye makes it easy to see the arteries in your brain on a CT scan.
• Angiogram: During an angiogram, a catheter is inserted into an artery and threaded through the circulatory system up to the brain. A dye is then injected through the catheter. This dye makes blood flow easier to see on X-rays.

Treatment for a subarachnoid hemorrhage

Once diagnosed, the goal is to stop the bleeding, prevent further complications and promote healing. Your treatment plan might involve:

• Medications: Your doctor may give you medications to control blood pressure, prevent blood clots and reduce brain swelling.
• Bed rest: Rest allows your brain to recover from the trauma.
• Surgery: Clipping or coiling the ruptured aneurysm or repairing AVMs to prevent future bleeds.

Recovering from a subarachnoid hemorrhage

The prognosis for subarachnoid hemorrhage varies depending on the severity of the bleeding and the timeliness of treatment. Some people may recover fully with no long-term effects, while others may experience permanent brain damage.

To aid in your recovery, your doctor may recommend:

• Physical therapy: To regain lost muscle function and coordination.
• Speech therapy: To relearn language skills if affected by the bleed.
• Occupational therapy: To adapt to any cognitive or emotional changes.
• Support groups: To connect you with others who understand the challenges you face.

Preventing a subarachnoid hemorrhage

While predicting a subarachnoid hemorrhage can be tricky, taking preventive measures can help prevent them. These include:

• Manage your blood pressure.
• Make healthy lifestyle changes.
• Quit smoking, limit alcohol intake and maintain a healthy weight.
• Get regularly screened for aneurysms if you have a family history or other risk factors.