A subarachnoid hemorrhage (SAH) is bleeding in the space that surrounds the brain. This can raise pressure around the brain. SAH can be deadly.
SAH may be caused by:
SAH is more common in people who are aged 50 years and older. Other things that may raise the risk are:
Problems may be:
- Sudden, severe headache
- Nausea and vomiting
- Stiff neck
- Light sensitivity
- Loss of consciousness
The doctor will ask about your symptoms and health history. A physical exam will be done. This may be enough to suspect the diagnosis.
Pictures may be taken of the brain and the structures around it. This can be done with:
The fluid in the spine may need to be tested. This can be done with a lumbar puncture.
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Emergency care is needed right away. The goals of treatment are to:
- Stop the bleeding
- Limit harm to the brain
- Reduce the risk of another SAH
- Surgery to stop an aneurysm from bleeding
- Medicines to help blood flow to the brain, to ease pain, and to treat other symptoms, such as seizures
Rehabilitation will be needed when a person is stable. This may include speech, physical, and occupational therapy.
SAH cannot always be prevented. To lower the risk:
- Manage high blood pressure
- Avoid using tobacco
- Limit alcohol
- Eat a healthful diet
- Macdonald RL, Schweizer TA. Spontaneous subarachnoid haemorrhage. Lancet. 2017 Feb 11;389(10069):655-666.
- Subarachnoid hemorrhage. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/subarachnoid-hemorrhage. Accessed October 5, 2020.
- Rimas Lukas, MD
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