Subarachnoid Hemorrhage

What Is Subarachnoid Hemorrhage?

Subarachnoid hemorrhage (SAH) is a life-threatening condition caused by bleeding into the space between the brain and the thin tissues that cover it, known as the subarachnoid space. It is a type of hemorrhagic stroke and requires emergency medical attention.

Causes and Risk Factors

SAH is most commonly caused by:

• Ruptured brain aneurysm (accounts for ~75–85% of non-traumatic cases)
• Head trauma (e.g., falls, car accidents)
• Arteriovenous malformation (AVM) – tangled blood vessels that rupture
• Vasculitis – inflammation of blood vessels
• Bleeding disorders or use of blood thinners

Risk factors include:

• High blood pressure
• Smoking
• Alcohol abuse
• Family history of aneurysms or AVMs
• Use of stimulants (e.g., cocaine)
• Age 40–65 (peak incidence)

Symptoms of Subarachnoid Hemorrhage

• Sudden, severe headache (often described as a “thunderclap headache”)
• Nausea and vomiting
• Stiff neck
• Sensitivity to light
• Loss of consciousness
• Seizures
• Confusion or trouble speaking
• Vision changes or double vision
• Weakness or numbness on one side of the body

Diagnosis

Diagnosis typically involves:

• CT scan – first-line imaging to detect bleeding
• MRI – for detailed brain imaging
• Cerebral angiography – to locate aneurysms or AVMs
• Lumbar puncture – to detect blood in cerebrospinal fluid if imaging is inconclusive

Treatment Options

Treatment focuses on stabilizing the patient, stopping the bleeding, and preventing complications:

1. Surgical Interventions

• Clipping – placing a metal clip on the aneurysm
• Endovascular coiling – inserting coils to block blood flow into the aneurysm
• Flow diversion or embolization – for AVMs
• Decompressive craniectomy – in cases of severe brain swelling [Subarachno…ayo Clinic], [Subarachno…nd Options]

2. Medications

• Nimodipine – a calcium channel blocker to prevent vasospasm and delayed cerebral ischemia
• Pain relievers and anticonvulsants
• Blood pressure management

3. Supportive Care

• ICU monitoring
• Ventilator support if needed
• Rehabilitation for neurological recovery

Prognosis

• Early treatment improves survival and reduces complications
• Risk of rebleeding is highest within the first 7 days
• Long-term effects may include cognitive deficits, physical disability, or seizures

Ready to Take the Next Step?

Call us at (561) 433-4444 to schedule a consultation or make an appointment.
Let our experienced doctors help you manage subarachnoid hemorrhage and protect your brain health.