Subarachnoid hemorrhage (patient information)

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What is subarachnoid hemorrhage?

How do I know if I have subarachnoid hemorrhage and what are the symptoms of subarachnoid hemorrhage?

Severe headache: Headache is the main symptom. It often starts suddenly and starts after a popping or snapping feeling in the head.
Speech disturbance
Weakness on one side of the body
Numbness
Neck pain
Double vision
Nausea and vomiting
Sudden or decreased consciousness
Personality changes such as confusion and irritability

Who is at risk for subarachnoid hemorrhage?

Cerebral arteriovenous malformation
Cerebral aneurysm
Head injury
Polycystic kidney disease
Hypertension
Smoking
Idiopathic

How to know you have subarachnoid hemorrhage?

Medical history, physical examination and neurological examation
Head noncontrast CT: Head CT may show evidence of aneurism and hemorrhage area. In some cases, CT scan may be normal.
Magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA): These images are occasionally used to diagnose a subarachnoid hemorrhage or find other associated conditions.
Cerebral angiography: This test can show small aneurysms or other vascular problems. It can locate the exact point of the bleed and can tell whether there is blood vessel spasm or not.
Lumbar puncture: When your severe headache is suspected subarachnoid hemorrhage but head CT shows normal, the doctor may order this test. During this procedure, the patient lies on the side, with knees pulled up toward the chest, and chin tucked downward. After injecting the anesthetic into the lower spine, the doctor insert a spinal needle into the lower back area to measure CSF pressure and collect a sample. Patients with subarachnoid hemorrhage will have blood in the spinal fluid.

When to seek urgent medical care?

Go to emergency department or call 911 as soon as possible when you feel severe headache.

Treatment options

Treatment for subarachnoid hemorrhage depends on the underlying cause of the bleeding and the extent of damage to the brain. The goal of treatment is to save the paptient's life, stop the bleeding and damage to the brain, relieve symptoms, and prevent complications and reduce the risk of recurrence.

Absolute bedrest and close monitoring of vital signs. During the three weeks immediately following the hemorrhage, it is very important since the complications and rerupture are most likely to occur.
Intubation and mechanical ventilation, supplemental oxygen and intravenous fluids.
Surgery: If the subarachnoid hemorrhage is caused by a ruptured aneurysm or a trauma. Surgery may be performed to stop the bleeding and repair the injury.
Medications: Medications may be used to prevent seizures, relieve headache, control blood pressure and aid relaxation.