Subarachnoid Hemorrhage

A subarachnoid hemorrhage is bleeding in the area between your brain and the membranes covering it. This space is called the subarachnoid space. It's a serious type of stroke, and needs immediate medical attention.

The most common sign of a subarachnoid hemorrhage is a sudden, extremely painful headache. People often describe it as the worst headache they've ever experienced. Other symptoms can include nausea, vomiting, a stiff neck, and more.

Bleeding in this area usually happens when a weakened or bulging blood vessel in the brain, called an aneurysm, bursts. Sometimes, a head injury is the cause. Other times, a tangled network of blood vessels in the brain, called an arteriovenous malformation (AVM), can cause the bleeding. Underlying health conditions that affect blood vessels can also be a factor.

Without prompt treatment, a subarachnoid hemorrhage can cause lasting brain damage or even death. Getting immediate medical care is crucial.

A sudden, severe headache is often the first sign of a subarachnoid hemorrhage. This headache comes on very quickly and feels intensely painful, sometimes described as the worst headache a person has ever had. This isn't a headache that builds gradually; it's a sharp, intense pain that appears out of nowhere.

Along with the sudden, terrible headache, other symptoms can include:

• Nausea: Feeling sick to your stomach.
• Vomiting: Throwing up.
• Stiff neck or neck pain: Difficulty moving your neck.
• Vision changes: Problems seeing clearly.
• Brief loss of consciousness: Passing out for a short time.

A subarachnoid hemorrhage is a serious medical emergency. It requires immediate attention. If you experience a sudden, extremely painful headache, or any of the other symptoms listed above, seek immediate medical care. This is especially important if you have a history of brain aneurysms or a recent head injury.

If you see someone experiencing a sudden, severe headache or loss of consciousness, call 911 or your local emergency number immediately. Time is critical in these situations, and prompt medical attention can greatly improve the chances of a positive outcome.

A subarachnoid hemorrhage is a serious medical problem that needs immediate attention.

Call for help right away if you have a sudden, intense headache or any other signs of a subarachnoid hemorrhage. This is crucial if you've been diagnosed with a brain aneurysm or have recently had a head injury. A subarachnoid hemorrhage happens when bleeding occurs in the space surrounding the brain. This bleeding can cause a lot of pressure on the brain, leading to serious complications.

If you see someone experiencing a sudden, severe headache or losing consciousness, call 911 or your local emergency number immediately. Prompt action is essential in these situations.

Subarachnoid hemorrhages happen when blood leaks into the space between the brain and the tissues that cover it. This space is called the subarachnoid space. Several things can cause this bleeding:

• Brain aneurysms: A brain aneurysm is like a bulge or weakness in a blood vessel in the brain. Imagine a balloon that's thin in one spot. If that spot bursts, blood leaks out into the surrounding area, causing a subarachnoid hemorrhage. This is the most frequent reason for this type of bleeding.

• Head injuries: A bump or trauma to the head, from a car accident, fall, or assault, can damage blood vessels in the brain. This damage can lead to bleeding into the subarachnoid space.

• Arteriovenous malformations (AVMs): Sometimes, blood vessels in the brain don't connect normally. They form a tangled web, like a maze of blood vessels. If this tangled network bursts, it can release blood into the subarachnoid space.

• Blood vessel inflammation (vasculitis): Vasculitis is when the blood vessels become inflamed and swollen. This inflammation can cause the blood vessel walls to get thicker and narrower. This can lead to the formation of blood clots or aneurysms, both of which can rupture and cause bleeding.

In short, a subarachnoid hemorrhage happens when a blood vessel in the brain bursts, releasing blood into the space surrounding the brain. This can be caused by various factors, including weakened blood vessels, head trauma, abnormal blood vessel structures, or inflammation of the blood vessels.

Some things that raise your chances of a subarachnoid hemorrhage are beyond your control. These include:

• Age: Most subarachnoid hemorrhages from aneurysms happen to people between 55 and 60. Women in their 50s and 60s are especially at higher risk. This is because as we get older, our blood vessels can weaken and become more prone to problems.
• Family history: If a close blood relative (like a parent, child, or sibling) has had a brain aneurysm, you have a higher chance of developing one yourself. This means your genes might play a role in your risk.
• Certain medical conditions: Some health problems increase the risk of a subarachnoid hemorrhage. These include conditions like Ehlers-Danlos syndrome, Marfan syndrome, neurofibromatosis type 1, and polycystic kidney disease. These conditions can affect the strength and elasticity of blood vessels, making them more vulnerable to bursting.

If you have two or more close relatives who've had brain aneurysms, or if you've already had a subarachnoid hemorrhage, you might want to talk to your doctor about getting checked for aneurysms. Early detection can often help prevent serious problems.

However, there are some risk factors that you can control. These include:

• Smoking: Smoking damages blood vessels and increases the likelihood of them weakening and bursting.
• Heavy alcohol use: Drinking too much alcohol can also damage blood vessels and increase your risk.
• Drug use: Illicit drugs like cocaine and methamphetamine can cause significant stress on your blood vessels and increase the chances of a hemorrhage. These substances can significantly affect blood vessel health.

It's important to remember that these are just factors that increase your risk. Many people with these risk factors never develop a subarachnoid hemorrhage. However, understanding these factors can help you make healthier choices to reduce your risk.

Diagnosing a subarachnoid hemorrhage (bleeding in the space around the brain) often involves several imaging tests. These tests help doctors see what's happening inside your head.

1. CT Scan: This is a common imaging test that uses X-rays to create detailed pictures of the inside of your body. It's very good at finding bleeding in the brain. However, if you have very low levels of red blood cells or if the bleed is very small, a CT scan might miss it. To get a clearer view of the blood vessels, your doctor might inject a special dye (contrast dye). This is called a CT angiogram.

2. MRI Scan: Magnetic Resonance Imaging (MRI) is another imaging technique. It uses magnets and radio waves to create detailed images. MRI can sometimes show signs of a subarachnoid hemorrhage even when a CT scan doesn't. Like with CT scans, your doctor might give you a contrast dye injection (an MR angiogram) to see your blood vessels more clearly.

3. Cerebral Angiography: This is a more specialized test used to get a very detailed look at the blood vessels in your brain. A thin tube (catheter) is carefully inserted into an artery and guided to your brain. Dye is then injected into the blood vessels. This allows doctors to see the blood vessels under X-ray. This test might be needed if other imaging tests aren't clear about the cause of the bleeding or if a subarachnoid hemorrhage is suspected but not easily seen. Sometimes, an aneurysm (a bulge in a blood vessel) isn't seen on the initial angiogram. If this happens, your doctor might recommend a second angiogram.

4. Lumbar Puncture: Sometimes, even after these imaging tests, a subarachnoid hemorrhage might not be immediately obvious. In these cases, your doctor might perform a lumbar puncture. This involves inserting a needle into your lower back to collect a small sample of cerebrospinal fluid (CSF). CSF surrounds the brain and spinal cord. If blood is found in the CSF, it's a strong sign that a subarachnoid hemorrhage is present. This is especially helpful when initial imaging tests haven't shown the bleeding.