What is a subarachnoid hemorrhage?
A subarachnoid hemorrhage is bleeding in the space that surrounds the brain. It's a medical emergency that can be fatal or cause long-lasting brain damage.
Subarachnoid hemorrhage happens when a blood vessel in your brain bursts
You get a sudden, severe headache and you may pass out
Doctors may do surgery to try to stop the bleeding
People who have any symptom of a subarachnoid hemorrhage should go to an emergency department immediately.
Bursts and Breaks: Causes of Hemorrhagic Stroke
When blood vessels of the brain are weak, abnormal, or under unusual pressure, a hemorrhagic stroke can occur. In hemorrhagic strokes, bleeding may occur within the brain, as an intracerebral hemorrhage. Or bleeding may occur between the inner and middle layer of tissue covering the brain (in the subarachnoid space), as a subarachnoid hemorrhage.
What causes a subarachnoid hemorrhage?
A subarachnoid hemorrhage can be caused by a head injury (for example, from a car crash).
A subarachnoid hemorrhage not caused by injury is usually caused by an aneurysm bursting in your brain.
Aneurysms are bulges in a weakened area of a blood vessel's wall. Usually, you're born with these aneurysms. Sometimes aneurysms develop later from having high blood pressure High Blood Pressure Each heart beat pushes blood through your arteries. Arteries are the blood vessels that carry blood from your heart to your body. Blood pressure is the pressure of blood in your arteries. Without... read more for many years. You may have more than one aneurysm in your brain.
What are the symptoms of a subarachnoid hemorrhage?
When an aneurysm ruptures it usually causes:
Sudden, severe headache (sometimes called a thunderclap headache)
Almost half of people with a subarachnoid hemorrhage die before getting to a hospital. Some people remain in a coma or unconscious. People who wake up may be confused and sleepy and have:
A stiff neck
Vomiting and dizziness
You may recover completely or be left with brain damage.
Later on, if you have more than one aneurysm, those aneurysms can burst too, giving you another hemorrhage.
How will my doctor know if I had a subarachnoid hemorrhage?
Doctors will usually suspect subarachnoid hemorrhage based on your symptoms. To make sure they're right, they'll do tests right away to see if your brain is bleeding and where it's bleeding:
CT (computed tomogrpahy) scan Computed Tomography A CT scan uses a large machine shaped like a large donut to take x-rays from many angles. A computer then takes the x-rays and creates many detailed pictures of the inside of your body. Each... read more or MRI Magnetic Resonance Imaging (MRI) MRI is a test that uses a machine with a powerful magnet to make pictures of the inside of your body. A computer creates a series of detailed pictures. Each picture looks like a slice taken... read more (magnetic resonance imaging)
Sometimes angiography Angiography Angiography is a medical test that takes pictures of your blood vessels using x-rays. The picture taken is called an angiogram. Doctors usually need pictures of only 1 or 2 blood vessels in... read more to get detailed pictures of the blood vessels inside your brain
Sometimes, a spinal tap Spinal Tap Spinal fluid is a liquid that surrounds your brain and spinal cord. Spinal fluid helps cushion your brain if you hit your head or fall. Spinal fluid moves freely around your brain and spinal... read more (when doctors use a long, thin needle to take some fluid from your spine to check for blood)
How do doctors treat a subarachnoid hemorrhage?
Doctors will treat the problems that cause your bleeding. They'll have you stay in a hospital or stroke center where you may get:
Bed rest with no activity
Medicine to relieve your headache (no aspirin or ibuprofen as these can cause more bleeding)
Medicine and fluids to keep your blood pressure at the right level
Sometimes medicine to prevent blood vessel spasm and subsequent ischemic stroke
Sometimes, doctors put a small metal coil in the leaking aneurysm or do surgery to close it
If you have more than one aneurysm, doctors will usually treat those too, so they don't bleed later
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