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
| 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 |
Investigation–
- 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