Subarachnoid hemorrhage is a serious brain related disorder which can lead to stroke and sometime death of a person. The disease is caused due to hemorrhage in subarachnoid space that surrounds the brain. Between the skull and the brain, there is a space called subarachnoid space. The area is filled with cerebrospinal fluid which functions as cushion to protect the brain.
Head injury, rupture of aneurysm and malformation of the blood vessel supplying the brain tissue are the primary causes for hemorrhage in this space. Subarachnoid hemorrhage usually occurs in people over the age of 50.
Treatment varies according to the underlying cause. Medication as well as surgical intervention in some cases may be needed. Depending on the severity, patients may recover and survive with disability. Some patients may not recover and die.
Common Causes Of Subarachnoid Hemorrhage
There is an area between the brain and the skull called subarachnoid space. Cerebrospinal fluid circulates in this space. It acts as a cushion and protects the brain from minor trauma and sudden jerks. However, when hemorrhage occurs in this area, it increases pressure on the brain. Gradually the brain cells are damaged due to insufficient supply of oxygen rich blood.
Hemorrhage is caused when blood leaks out from the artery. It can be due to trauma to the brain or rupture of the aneurysm or due to malformation in the blood vessels supplying the brain. The hematoma thus formed can crush the brain or can push aside the brain tissue. A large hematoma formed after hemorrhage can block the cerebrospinal fluid. All these factors can lead to brain stroke.
Signs And Symptoms Of Subarachnoid Hemorrhage
Subarachnoid hemorrhage has varied symptoms. They depend on the severity of the condition and amount of blood collected in the brain. The onset of symptoms is always sudden and abrupt. Headache is the most common symptom which develops suddenly. The pain is at its extreme and unbearable. It is not like a common headache that people experience regularly.
Some people may have a popping sensation in the head before the headache starts. Along with it, patient may also present with other accompanying symptoms such as;
- Pain and stiffness of neck.
- Numb feeling in the body.
- Uncontrolled nausea and vomiting.
- Blurred vision
- Patient cannot bear bright light.
- Increased irritability and disorientation.
- The size of both the pupils is different. One may be larger than the other.
Diagnosis And Treatment Of Subarachnoid Hemorrhage
Diagnosis of subarachnoid hemorrhage is usually made clinically by the doctor. He may suspect it from the symptoms and clinical examination, past and present medical history. While examination, the doctor will find neck rigidity and changes in the pupil of the eye. Aside from the examination, diagnostic tests will be useful to determine the area of bleeding. MRI, CT scan etc are valuable imaging techniques to know the exact location of bleeding.
Subarachnoid hemorrhage is life threatening condition; hence immediate treatment is extremely important for better outcome and prevention of permanent damage to the brain. In majority cases of subarachnoid hemorrhage, surgical repair of the leaking vessel or aneurysm is the only choice to remove the pool of collected blood and prevent further bleeding.
Craniotomy is a surgical method in which a hole is made into the skull and the aneurysm of the vessel is clipped. In some cases other method called endovascular coiling is used to stop bleeding. This treatment consists of coiling around the aneurysm. It secures the vessel from bleeding.
All life support measures are provided to the patient who is under coma. Medicines are administered to prevent spasm of the arteries, seizures, headache and reduce high blood pressure as well as raised intracranial pressure.
Prognosis: The prognosis of subarachnoid hemorrhage depends on the amount of bleeding in the space as well as number of complications that may follow after the event. While many patients recover completely from the illness, there are many others who may have some form of disability or may die.