Subarachnoid haemorrhage is bleeding in the space between the brain and the lining that covers the brain, called the arachnoid. Like all strokes, a subarachnoid haemorrhage 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, and Hypertension increase the risk of the aneurysm bursting
- Arteriovenous malformations
These are the direct connections between the arteries and the veins, (without the capillaries) to reduce the speed and pressure of the blood.
Severe head injury
Symptoms and signs of subarachnoid haemorrhage
- Apathy
- Delirium
- Depression
- Impaired or total loss of consciousness.
- Slurred speech
- Stiff neck
- Sudden and severe headache (thunderclap headache)
- Vomiting
Subarachnoid grading
Fischer scale
| Grade | Description |
| 1 | No clot seen on CT scan |
| 2 | Diffuse thin layer of subarachnoid clot (<1 mm thickness) |
| 3 | Localized clot or thicker layer of subarachnoid clot (>1 mm thickness) |
| 4 | Intracerebral or intraventricular clot with diffuse or no subarachnoid clot |
Investigations
- Computerized tomography (CT) scan
- Lumbar puncture
- MRI scan
- Doppler ultrasound
 Treatment
- Oxygen therapy
- Medication
- Surgery
- Neurosurgical clipping
- 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