Subarachnoid Hemorrhage

A subarachnoid hemorrhage means that there is bleeding in the space that surrounds the brain. Most often, it occurs when a weak area in a blood vessel (aneurysm) on the surface of the brain bursts and leaks. The blood then builds up around the brain and inside the skull increasing pressure on the brain. This can cause brain cell damage, life-long complications, and disabilities. A subarachnoid hemorrhage is the least common type of hemorrhagic stroke, after intracerebral hemorrhage, which is the deadliest type of stroke.

When an aneurysm is located in the brain, it's called a cerebral, intracerebral, or intracranial aneurysm. A cerebral aneurysm often develops over a long period of time and may not cause any symptoms before it bursts or ruptures. Most aneurysms develop after age 40.

## Symptoms

The symptoms of a subarachnoid hemorrhage is the same as an ischemic stroke and an intracerebral hemorrhage, like drooping of one side of the face, numbness or tingling or weakness or paralysis, speech problems, blindness, memory loss, deafness, attention problems, coordination problems, and balance problems. However, fainting, loss of consciousness, coma, headaches, nausea/vomiting, and seizures occur more often in hemorrhagic strokes than ischemic strokes due to the increased intracranial pressure from the blood leaking the brain.

The headache from a subarachnoid hemorrhage is known as a "thunderclap headache". A thunderclap headache is a severe headache.

## Causes

A subarachnoid hemorrhage may occur as a complication of a type of stroke called a hemorrhagic stroke, or bleeding inside the brain. This is different from an ischemic stroke, which is caused by a blood clot.

This bleeding can sometimes cut through the brain tissue and leak into the area outside the brain (called the subarachnoid space). This is called a subarachnoid hemorrhage and can be life threatening. The blood from the hemorrhage can compress or displace vital brain tissue. A severe hemorrhage can cause a coma, or leave you paralyzed.

## Treatment

A subarachnoid hemorrhage is a medical emergency. Immediate treatment is essential to help reduce the risk for permanent brain damage. The main goal of treating a subarachnoid hemorrhage is to stop the bleeding. Often, a doctor may do surgery to place a small clip on the blood vessel to stop blood from leaking into the brain.

Some types of aneurysms can be treated with an endovascular coil. This procedure is done by either a radiologist or a neurosurgeon. It requires making a tiny incision in your groin and passing a thin tube called a catheter through the artery in your leg up to the artery in your head that is bleeding. Recovery time from this type of treatment is much shorter than traditional surgery; however, not all aneurysms can be treated this way. Your doctor can determine if you are a candidate for this treatment after doing an angiogram.

Part of the long-term treatment of a subarachnoid hemorrhage involves addressing any risk factors that may have helped trigger the hemorrhage. One of the most significant risk factors is smoking. If you smoke, you need to quit. Gaining better control of contributing conditions such as diabetes, high cholesterol, or high blood pressure are also important. Maintaining a healthy body weight, and eating a balanced diet can also reduce your risk.