About Subarachnoid Hemorrhage
The majority of SAH cases are caused by the rupture of an intracranial aneurysm, which is a weak spot in a blood vessel wall.
Non-modifiable risk factors are factors that cannot be changed or controlled. Non-modifiable risk factors for SAH include:
- Sex: Women have a slightly higher risk of developing SAH compared to men.
- Age: SAH is more common in individuals over the age of 40.
- Family history: Having a family member who has had an SAH increases the risk.
Modifiable risk factors are factors that can be influenced or changed. Modifiable risk factors for SAH include:
- Smoking: Cigarette smoking significantly increases the risk of SAH.
- Hypertension: High blood pressure is a major risk factor for SAH.
- Excessive alcohol intake: Heavy alcohol consumption can increase the risk of SAH.
If you have concerns about your risk for SAH, it's best to consult with your healthcare professional who can provide personalized advice and guidance.
The most common early symptoms of SAH include:
- Sudden and severe headache, often described as the worst headache of one's life
- Throbbing headache near the back of the head
- Stiff neck
- Nausea and vomiting
As SAH progresses or becomes more severe, additional symptoms may occur, such as:
- Loss of consciousness
- Slurred speech
- Confusion or delirium
- Impaired consciousness
- Seizures
- Intraocular hemorrhage (bleeding into the eyeball)
- Difficulty lifting an eyelid
- Sharp rise in blood pressure
It's important to note that these symptoms can vary from person to person and may not always occur in every case. If you experience any of these symptoms, especially a sudden and severe headache, it is crucial to seek immediate medical attention. SAH can be a medical emergency, and early diagnosis and treatment are essential for the best possible outcome.
To diagnose SAH, the following examinations, tests, and procedures are commonly performed:
- Physical examination: A doctor will conduct a thorough physical examination, including a neurological examination, to assess your symptoms and overall condition.
- Brain imaging tests: Two commonly used imaging tests are computed tomography (CT) scan and magnetic resonance imaging (MRI) scan. CT scans provide quicker results, while MRI scans can provide more detailed images.
- Lumbar puncture (spinal tap): This procedure involves removing a small sample of cerebrospinal fluid from your back using a needle. It can confirm the presence of SAH, even if it doesn't show up on a CT scan.
- Brain angiography and MRI angiography: These tests evaluate blood flow patterns within your brain and can help detect an aneurysm or other abnormalities.
To determine the stage or severity of SAH, additional examinations, tests, and procedures may include:
- Xanthochromia test: This test examines the coloration of the cerebrospinal fluid after centrifugation to determine if it contains blood.
- Fisher Scale: This scale is used to assess the severity of bleeding in CT imaging and estimate the risk of vascular spasm.
- Vascular examinations: Angio-CT and angio-MR are performed to find the cause of bleeding, determine its location, and diagnose ruptured aneurysms.
- Subtractive angiography: This procedure is highly sensitive in diagnosing ruptured aneurysms.
It's important to consult with your healthcare professional for personalized advice regarding these examinations, tests, and procedures.
The goals of treatment for SAH are as follows:
- Prevent rebleeding:
- Medications may be used to prevent arteries from narrowing when they spasm, which commonly occurs after SAH. This helps to reduce the risk of rebleeding.
- Repair abnormal blood vessels:
- If the bleeding is caused by an abnormally formed blood vessel, surgery may be necessary to repair the vessel and prevent future hemorrhages.
- Treat aneurysms:
- Aneurysms can be repaired by placing a surgical clip. This helps to eliminate the risk of rupture and subsequent bleeding.
- Manage symptoms and complications:
- Early intervention by occupational and physical therapists can help patients regain strength and learn how to work around any new disabilities caused by the SAH. Hospitalization followed by rehabilitation can provide additional intensive therapy to improve physical and speaking function.
It is important to note that specific medications, therapies, procedures, or health behavior changes may vary depending on the individual case and should be discussed with a healthcare professional.
Medication dosing may be affected by many factors. Check with your health care professional about dosing for your individual situation. Other side effects can occur. Check with your health care professional or read the information provided with your medication for additional side effect information.