Subarachnoid Haemorrhage

Subarachnoid hemorrhage is bleeding in the space between the brain and the lining that covers the brain, called the arachnoid. Like all strokes, a subarachnoid hemorrhage is a medical emergency that requires immediate treatment to prevent serious complications, brain damage and death.

Causes —

Defects in the blood vessels

  • Aneurysms

Smoking, Alcoholism, Hypertension increases the risk of aneurysm bursting

  • Arteriovenous malformations

These are direct connection between the arteries and the veins, (without the capillaries) to reduce the speed and pressure of the blood.

Severe head injury

Symptoms And Signs-

  • Apathy
  • Delirium
  • Depression
  • Impaired or total loss of consciousness.
  • Slurred speech
  • Stiff neck
  • Sudden and severe headache (thunderclap headache)
  • Vomiting

Subarachnoid Grading-

Fischer scale

 

GradeDescription
1No clot seen on CT scan
2Diffuse thin layer of subarachnoid clot (<1 mm thickness)
3Localized clot or thicker layer of subarachnoid clot (>1 mm thickness)
4Intracerebral or intraventricular clot with diffuse or no subarachnoid clot

Investigation–

  • Computerized tomography (CT) scan
  • Lumbar puncture
  • MRI scan
  • Doppler ultrasound

 Treatment—

  • Oxygen therapy
  • Medication
  • Surgery
  1. Neurosurgical clipping
  2. Endovascular coiling

Complications–

  • Cerebral vasospasm
  • Epilepsy
  • Hydrocephalus

Prevention—

  • Undergo screening  for aneurysm every five years if you have two or more close blood relatives who have experienced a subarachnoid haemorrhage, (mother, father, brother, aunt or uncle; but not grandmother or grandfather).
  • Keep Blood pressure in control    

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