Subarachnoid hemorrhage: Difference between revisions
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{{Infobox medical condition | |||
| name = Subarachnoid hemorrhage | |||
| image = [[File:SubarachnoidP.png|alt=CT scan showing subarachnoid hemorrhage]] | |||
| caption = CT scan showing subarachnoid hemorrhage | |||
| field = [[Neurology]] | |||
| symptoms = [[Thunderclap headache]], [[vomiting]], [[confusion]], [[seizures]] | |||
| complications = [[Hydrocephalus]], [[cerebral vasospasm]], [[hyponatremia]] | |||
| onset = Sudden | |||
| duration = | |||
| types = [[Traumatic subarachnoid hemorrhage]], [[Aneurysmal subarachnoid hemorrhage]] | |||
| causes = [[Head injury]], [[ruptured cerebral aneurysm]] | |||
| risks = [[Hypertension]], [[smoking]], [[alcohol use disorder]], [[family history]] | |||
| diagnosis = [[CT scan]], [[lumbar puncture]] | |||
| differential = [[Meningitis]], [[migraine]], [[intracerebral hemorrhage]] | |||
| prevention = [[Blood pressure control]], [[smoking cessation]] | |||
| treatment = [[Surgical clipping]], [[endovascular coiling]], [[nimodipine]] | |||
| medication = [[Nimodipine]], [[pain management]] | |||
| prognosis = Variable, depends on severity and complications | |||
| frequency = 9 per 100,000 people per year | |||
| deaths = 40-50% mortality rate | |||
}} | |||
'''Subarachnoid hemorrhage''' (SAH) is a serious, life-threatening type of [[stroke]] caused by bleeding into the space surrounding the brain, known as the subarachnoid space.<ref>{{Cite journal |last=Macdonald |first=RL |title=Subarachnoid hemorrhage |journal=Lancet |volume=389 |issue=10069 |pages=655-666 |year=2017 |doi=10.1016/S0140-6736(16)30668-7}}</ref> This condition requires immediate medical attention and treatment to prevent severe disability or death. | '''Subarachnoid hemorrhage''' (SAH) is a serious, life-threatening type of [[stroke]] caused by bleeding into the space surrounding the brain, known as the subarachnoid space.<ref>{{Cite journal |last=Macdonald |first=RL |title=Subarachnoid hemorrhage |journal=Lancet |volume=389 |issue=10069 |pages=655-666 |year=2017 |doi=10.1016/S0140-6736(16)30668-7}}</ref> This condition requires immediate medical attention and treatment to prevent severe disability or death. | ||
[[File:Subarachnoid hemorrhage CT.jpg|thumb|Subarachnoid hemorrhage CT]] | [[File:Subarachnoid hemorrhage CT.jpg|left|thumb|Subarachnoid hemorrhage CT]] | ||
==Clinical Presentation== | ==Clinical Presentation== | ||
Symptoms of a subarachnoid hemorrhage can include a sudden severe headache (often described as "the worst headache of my life"), vomiting, loss of consciousness, and neurological symptoms such as blurred or double vision, difficulty speaking, and weakness or numbness on one side of the body.<ref>{{Cite journal |last=Kowalski |first=RG |title=Initial misdiagnosis and outcome after subarachnoid hemorrhage |journal=JAMA |volume=291 |issue=7 |pages=866-869 |year=2004 |doi=10.1001/jama.291.7.866}}</ref> | Symptoms of a subarachnoid hemorrhage can include a sudden severe headache (often described as "the worst headache of my life"), vomiting, loss of consciousness, and neurological symptoms such as blurred or double vision, difficulty speaking, and weakness or numbness on one side of the body.<ref>{{Cite journal |last=Kowalski |first=RG |title=Initial misdiagnosis and outcome after subarachnoid hemorrhage |journal=JAMA |volume=291 |issue=7 |pages=866-869 |year=2004 |doi=10.1001/jama.291.7.866}}</ref> | ||
[[File:Subarachnoid haemorrhage.jpg|thumb|Subarachnoid haemorrhage]] | [[File:Subarachnoid haemorrhage.jpg|left|thumb|Subarachnoid haemorrhage]] | ||
==Etiology== | ==Etiology== | ||
The most common cause of a subarachnoid hemorrhage is a ruptured [[aneurysm]], a weakened and bulging section of a blood vessel. Other causes can include [[arteriovenous malformation]] (AVM), traumatic brain injury, or certain blood clotting disorders.<ref>{{Cite journal |last=van Gijn |first=J |title=Subarachnoid haemorrhage |journal=Lancet |volume=369 |issue=9558 |pages=306-318 |year=2007 |doi=10.1016/S0140-6736(07)60153-6}}</ref> | The most common cause of a subarachnoid hemorrhage is a ruptured [[aneurysm]], a weakened and bulging section of a blood vessel. Other causes can include [[arteriovenous malformation]] (AVM), traumatic brain injury, or certain blood clotting disorders.<ref>{{Cite journal |last=van Gijn |first=J |title=Subarachnoid haemorrhage |journal=Lancet |volume=369 |issue=9558 |pages=306-318 |year=2007 |doi=10.1016/S0140-6736(07)60153-6}}</ref> | ||
==Diagnosis== | ==Diagnosis== | ||
Diagnosis involves a series of tests to detect blood in the subarachnoid space and to identify the source of the bleeding. These tests can include a computed tomography (CT) scan, lumbar puncture (also known as a spinal tap), and cerebral angiogram.<ref>{{Cite journal |last=Connolly |first=ES |title=Guidelines for the management of aneurysmal subarachnoid hemorrhage |journal=Stroke |volume=43 |issue=6 |pages=1711-1737 |year=2012 |doi=10.1161/STR.0b013e3182587839}}</ref> | Diagnosis involves a series of tests to detect blood in the subarachnoid space and to identify the source of the bleeding. These tests can include a computed tomography (CT) scan, lumbar puncture (also known as a spinal tap), and cerebral angiogram.<ref>{{Cite journal |last=Connolly |first=ES |title=Guidelines for the management of aneurysmal subarachnoid hemorrhage |journal=Stroke |volume=43 |issue=6 |pages=1711-1737 |year=2012 |doi=10.1161/STR.0b013e3182587839}}</ref> | ||
==Treatment== | ==Treatment== | ||
Treatment aims to stop the bleeding, prevent vasospasm (a complication characterized by narrowing of the blood vessels), and minimize brain damage. This typically involves surgery to repair the aneurysm, medications to control symptoms and prevent complications, and rehabilitative therapy to assist in recovery.<ref>{{Cite journal |last=Stienen |first=MN |title=Predictors of In-Hospital Death After Aneurysmal Subarachnoid Hemorrhage: Analysis of a Nationwide Database (Swiss SOS [Swiss Study on Aneurysmal Subarachnoid Hemorrhage]) |journal=Stroke |volume=49 |issue=2 |pages=333-340 |year=2018 |doi=10.1161/STROKEAHA.117.019339}}</ref> | Treatment aims to stop the bleeding, prevent vasospasm (a complication characterized by narrowing of the blood vessels), and minimize brain damage. This typically involves surgery to repair the aneurysm, medications to control symptoms and prevent complications, and rehabilitative therapy to assist in recovery.<ref>{{Cite journal |last=Stienen |first=MN |title=Predictors of In-Hospital Death After Aneurysmal Subarachnoid Hemorrhage: Analysis of a Nationwide Database (Swiss SOS [Swiss Study on Aneurysmal Subarachnoid Hemorrhage]) |journal=Stroke |volume=49 |issue=2 |pages=333-340 |year=2018 |doi=10.1161/STROKEAHA.117.019339}}</ref> | ||
==Prognosis== | ==Prognosis== | ||
Prognosis following a subarachnoid hemorrhage depends on a number of factors including the patient's age, general health, and the severity of the hemorrhage. Despite improvements in medical and surgical treatment, SAH remains a condition with high mortality and morbidity.<ref>{{Cite journal |last=Etminan |first=N |title=Worldwide incidence of aneurysmal subarachnoid hemorrhage according to region, time period, blood pressure, and smoking prevalence in the population: a systematic review and meta-analysis |journal=JAMA neurology |volume=76 |issue=5 |pages=588-597 |year=2019 |doi=10.1001/jamaneurol.2018.4613}}</ref> | Prognosis following a subarachnoid hemorrhage depends on a number of factors including the patient's age, general health, and the severity of the hemorrhage. Despite improvements in medical and surgical treatment, SAH remains a condition with high mortality and morbidity.<ref>{{Cite journal |last=Etminan |first=N |title=Worldwide incidence of aneurysmal subarachnoid hemorrhage according to region, time period, blood pressure, and smoking prevalence in the population: a systematic review and meta-analysis |journal=JAMA neurology |volume=76 |issue=5 |pages=588-597 |year=2019 |doi=10.1001/jamaneurol.2018.4613}}</ref> | ||
==Prevention== | ==Prevention== | ||
Prevention of SAH is primarily focused on controlling risk factors for aneurysm formation and rupture, such as hypertension and smoking. In some cases, screening and preventive treatment may be recommended for individuals with a family history of aneurysmal SAH.<ref>{{Cite journal |last=Vlak |first=MH |title=Prevalence of unruptured intracranial aneurysms, with emphasis on sex, age, comorbidity, country, and time period: a systematic review and meta-analysis |journal=Lancet neurology |volume=10 |issue=7 |pages=626-636 |year=2011 |doi=10.1016/S1474-4422(11)70109-0}}</ref> | Prevention of SAH is primarily focused on controlling risk factors for aneurysm formation and rupture, such as hypertension and smoking. In some cases, screening and preventive treatment may be recommended for individuals with a family history of aneurysmal SAH.<ref>{{Cite journal |last=Vlak |first=MH |title=Prevalence of unruptured intracranial aneurysms, with emphasis on sex, age, comorbidity, country, and time period: a systematic review and meta-analysis |journal=Lancet neurology |volume=10 |issue=7 |pages=626-636 |year=2011 |doi=10.1016/S1474-4422(11)70109-0}}</ref> | ||
==See Also== | ==See Also== | ||
* [[Aneurysm]] | * [[Aneurysm]] | ||
| Line 25: | Line 41: | ||
* [[Cerebrovascular Diseases]] | * [[Cerebrovascular Diseases]] | ||
* [[Neurosurgery]] | * [[Neurosurgery]] | ||
==References== | ==References== | ||
<references/> | <references/> | ||
Latest revision as of 20:17, 8 April 2025
Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD's medical weight loss NYC, sleep center NYC
Philadelphia medical weight loss and Philadelphia sleep clinics
| Subarachnoid hemorrhage | |
|---|---|
| |
| Synonyms | N/A |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Thunderclap headache, vomiting, confusion, seizures |
| Complications | Hydrocephalus, cerebral vasospasm, hyponatremia |
| Onset | Sudden |
| Duration | |
| Types | Traumatic subarachnoid hemorrhage, Aneurysmal subarachnoid hemorrhage |
| Causes | Head injury, ruptured cerebral aneurysm |
| Risks | Hypertension, smoking, alcohol use disorder, family history |
| Diagnosis | CT scan, lumbar puncture |
| Differential diagnosis | Meningitis, migraine, intracerebral hemorrhage |
| Prevention | Blood pressure control, smoking cessation |
| Treatment | Surgical clipping, endovascular coiling, nimodipine |
| Medication | Nimodipine, pain management |
| Prognosis | Variable, depends on severity and complications |
| Frequency | 9 per 100,000 people per year |
| Deaths | 40-50% mortality rate |
Subarachnoid hemorrhage (SAH) is a serious, life-threatening type of stroke caused by bleeding into the space surrounding the brain, known as the subarachnoid space.<ref>Macdonald, RL,
Subarachnoid hemorrhage, Lancet, 2017, Vol. 389(Issue: 10069), pp. 655-666, DOI: 10.1016/S0140-6736(16)30668-7,</ref> This condition requires immediate medical attention and treatment to prevent severe disability or death.
Clinical Presentation[edit]
Symptoms of a subarachnoid hemorrhage can include a sudden severe headache (often described as "the worst headache of my life"), vomiting, loss of consciousness, and neurological symptoms such as blurred or double vision, difficulty speaking, and weakness or numbness on one side of the body.<ref>Kowalski, RG,
Initial misdiagnosis and outcome after subarachnoid hemorrhage, JAMA, 2004, Vol. 291(Issue: 7), pp. 866-869, DOI: 10.1001/jama.291.7.866,</ref>
Etiology[edit]
The most common cause of a subarachnoid hemorrhage is a ruptured aneurysm, a weakened and bulging section of a blood vessel. Other causes can include arteriovenous malformation (AVM), traumatic brain injury, or certain blood clotting disorders.<ref>van Gijn, J,
Subarachnoid haemorrhage, Lancet, 2007, Vol. 369(Issue: 9558), pp. 306-318, DOI: 10.1016/S0140-6736(07)60153-6,</ref>
Diagnosis[edit]
Diagnosis involves a series of tests to detect blood in the subarachnoid space and to identify the source of the bleeding. These tests can include a computed tomography (CT) scan, lumbar puncture (also known as a spinal tap), and cerebral angiogram.<ref>Connolly, ES,
Guidelines for the management of aneurysmal subarachnoid hemorrhage, Stroke, 2012, Vol. 43(Issue: 6), pp. 1711-1737, DOI: 10.1161/STR.0b013e3182587839,</ref>
Treatment[edit]
Treatment aims to stop the bleeding, prevent vasospasm (a complication characterized by narrowing of the blood vessels), and minimize brain damage. This typically involves surgery to repair the aneurysm, medications to control symptoms and prevent complications, and rehabilitative therapy to assist in recovery.<ref>Stienen, MN,
Predictors of In-Hospital Death After Aneurysmal Subarachnoid Hemorrhage: Analysis of a Nationwide Database (Swiss SOS [Swiss Study on Aneurysmal Subarachnoid Hemorrhage]), Stroke, 2018, Vol. 49(Issue: 2), pp. 333-340, DOI: 10.1161/STROKEAHA.117.019339,</ref>
Prognosis[edit]
Prognosis following a subarachnoid hemorrhage depends on a number of factors including the patient's age, general health, and the severity of the hemorrhage. Despite improvements in medical and surgical treatment, SAH remains a condition with high mortality and morbidity.<ref>Etminan, N,
Worldwide incidence of aneurysmal subarachnoid hemorrhage according to region, time period, blood pressure, and smoking prevalence in the population: a systematic review and meta-analysis, JAMA neurology, 2019, Vol. 76(Issue: 5), pp. 588-597, DOI: 10.1001/jamaneurol.2018.4613,</ref>
Prevention[edit]
Prevention of SAH is primarily focused on controlling risk factors for aneurysm formation and rupture, such as hypertension and smoking. In some cases, screening and preventive treatment may be recommended for individuals with a family history of aneurysmal SAH.<ref>Vlak, MH,
Prevalence of unruptured intracranial aneurysms, with emphasis on sex, age, comorbidity, country, and time period: a systematic review and meta-analysis, Lancet neurology, 2011, Vol. 10(Issue: 7), pp. 626-636, DOI: 10.1016/S1474-4422(11)70109-0,</ref>
See Also[edit]
References[edit]
<references/>
