Your browser is no longer supported

For the best possible experience using our website we recommend you upgrade to a newer version or another browser.

Your browser appears to have cookies disabled. For the best experience of this website, please enable cookies in your browser

We'll assume we have your consent to use cookies, for example so you won't need to log in each time you visit our site.
Learn more

Subarachnoid haemorrhage.

  • Comment

VOL: 101, ISSUE: 02, PAGE NO: 30

What is it?

 

What is it?
- Subarachnoid haemorrhage occurs when an artery under the arachnoid mater membrane surrounding the brain ruptures and blood leaks into the cerebrospinal fluid.

 

 

- The condition is potentially life-threatening and requires urgent medical attention.

 

 

- Subarachnoid haemorrhage is more common in women and older people (Brain Australia, 2003).

 

 

Causes
- Most subarachnoid haemorrhages are caused by a ‘berry’ aneurysm at a junction in the blood vessels.

 

 

- Berry aneurysms are present in about one per cent of the population, although only a very small proportion of these rupture.

 

 

- Arteriovenous malformation - a tangled mass of blood vessels linking arteries and veins present from birth - is a less common cause of subarachnoid haemorrhage.

 

 

- Smoking, hypertension and an alcohol consumption of >150g per week have been associated with increased risk of subarachnoid haemorrhage.

 

 

Symptoms
- Excruciating headache, usually of sudden onset, often at the back of the head.

 

 

- Nausea and vomiting.

 

 

- Tiredness.

 

 

- Loss of consciousness.

 

 

- Seizures.

 

 

- Confusion.

 

 

- Other symptoms may include stiff neck and aversion to bright light.

 

 

- Symptoms vary and depend on the severity of the haemorrhage. They are often similar to those associated with meningitis.

 

 

Diagnosis
- Initial diagnosis is usually based on the characteristic symptoms.Other tests are used to confirm the diagnosis and decide on treatment options. These include:

 

 

- Computerised tomography (CT) scan to show the source and quantity of bleeding; l Magnetic resonance imaging (MRI) and/or angiogram to locate the berry aneurysm if this is the cause of the haemorrhage; l Lumbar puncture to examine cerebrospinal fluid for the presence of blood.

 

 

Treatment
- Subarachnoid haemorrhage is an emergency and the patient must be transferred to hospital immediately.

 

 

- The timing of surgery depends on the patient’s condition.

 

 

- If the cause of haemorrhage is a berry aneurysm, craniotomy is usually required to seal off the aneurysm and prevent future bleeds.

 

 

- Alternatively, the aneurysm may by accessed arterially through a procedure known as endovascular embolisation or coiling.

 

 

- If the haemorrhage is due to arteriovenous malformation this will be removed by craniotomy.

 

 

- Some patients have additional aneurysms and may need further surgery to prevent future bleeds.

 

 

- Drugs will be prescribed as necessary for analgesia, to reduce the risk of vasoconstriction, control seizures or decrease blood pressure.

 

 

Complications
- Aneurysm rupture is fatal in 40 per cent or more cases.

 

 

- Half of survivors experience stroke-like deficits such as speech disturbance, weakness on one side of the body or double vision.

 

 

- Vasospasm in the days following haemorrhage may result in stroke.

 

 

- Postoperative jaw stiffness, headaches, pain or numbness around the scar may be experienced temporarily but should decrease.

 

 

- Occasionally epileptic seizures or hydrocephalus may occur.

 

 

- Intensive physical, occupational and speech therapy will help, but recovery may be slow and uneven.

 

 

Website: NHS Direct: www.nhsdirect.nhs.uk

  • Comment

Have your say

You must sign in to make a comment

Please remember that the submission of any material is governed by our Terms and Conditions and by submitting material you confirm your agreement to these Terms and Conditions. Links may be included in your comments but HTML is not permitted.