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Subarachnoid Hemorrhage

About Subarachnoid Hemorrhage and Treatments

A subarachnoid hemorrhage is a form of a stroke and comprises 1 to 7 percent of all strokes. This medical emergency can lead to death or severe disability. John C. Lincoln Neurocritical Care Unit at North Mountain Hospital now offers comprehensive treatment options for subarachnoid hemorrhages — traumatic and non-traumatic alike.

Subarachnoid hemorrhage can be caused by a head injury, cerebral aneurysm, use of blood thinners, bleeding disorders, bleeding from an arteriovenous malformation or an unknown cause. A subarachnoid hemorrhage occurs in an estimated 40 to 50 out of 100,000 people over the age of 30. It is slightly most common in women than men.

What Is a Subarachnoid Hemorrhage?

A subarachnoid hemorrhage is a serious, life-threatening type of stroke caused by bleeding in the area between the brain and the thin tissues that cover the brain called subarachnoid space. When blood is released into the subarachnoid space, it irritates the lining of the brain, increases pressure on the brain, and damages brain cells. During the same time, the oxygen-rich blood from the artery that is affected is now deprived of blood that goes to the brain, resulting in a stroke.

Symptoms of a Subarachnoid Hemorrhage

The main symptom of a subarachnoid hemorrhage is a severe headache that starts suddenly and is often worse near the back of the head. Patients often describe their pain as "the worst headache ever" and unlike any other type of headache pain. The headache may start after a popping or snapping feeling in the head. Other symptoms include:

  • Nausea and vomiting
  • Stiff neck
  • Sensitivity to light
  • Blurred or double vision
  • Loss of consciousness
  • Seizures

If you or someone you know if experiencing any symptoms of a subarachnoid hemorrhage, call 9-1-1 immediately.

Treatments for Subarachnoid Hemorrhage

At John C. Lincoln North Mountain Hospital, stabilizing the patient is our first priority. Our Neurocritical Care Unit has the skills, specialists and technologies for the best possible outcomes for subarachnoid hemorrhage patients. Treatments for subarachnoid hemorrhages vary depending on the underlying cause of the bleeding and the extent of damage to the brain.

Treatment Options

One of the first measures after a subarachnoid hemorrhage occurs is to stop the bleeding or prevent the risk of bleeding again. If a subarachnoid hemorrhage is from a ruptured aneurysm, surgery may be performed to stop the bleeding. Treatment options are either surgical or endovascular intervention.

Vasospasm

A vasospasm is event that narrows the artery and reduces the blood flow to the region of the brain that the artery feeds. Vasospasms occur in 70 percent of patients after a subarachnoid hemorrhage. Symptoms of a vasospasm include:

  • Weakness in an arm or leg.
  • Confusion.
  • Sleepiness.
  • Restlessness.

Vasospasms can be evaluated with Transcranial Doppler (TCD) ultrasounds that measure the blood flow through the arteries. Then they can monitor the severity of the spasm and determine to level of "Triple H Therapy" to use.

  • Hypertension: Involves increasing the blood pressure to force blood through the narrowed arteries.
  • Hypervolemia: Involves increasing IV fluids to make more blood volume.
  • Hemodilution: Involves making the blood thin and watery so that it flows more easily through narrowed arteries.

Recovery

Recovery from a subarachnoid hemorrhage largely depends on the severity. In general, one-third of patients who suffer from a subarachnoid hemorrhage will survive with good recovery. Patients may suffer from short-term and/or long term deficits as well. Common problems faced by patients following a brain injury include:

  • Physical limitations.
  • Short-term memory loss.
  • Speech and language deficits.
  • Weakness or paralysis in arms and legs.
  • Visual problems.
  • Side effects from medications.
  • Fatigue.
  • Headaches.
  • Lack of attention or concentration.
  • Personality changes.

For a referral to a neuro-specialist call 602-943-1111.