Summary about Disease
Subarachnoid hemorrhage (SAH) is bleeding in the space between the brain and the surrounding membrane (the subarachnoid space). It's a serious condition that can lead to brain damage, stroke, and even death. Most commonly, it's caused by a ruptured aneurysm, but other causes exist. Prompt diagnosis and treatment are crucial.
Symptoms
The hallmark symptom is a sudden, severe headache, often described as "the worst headache of my life." Other symptoms may include:
Stiff neck
Nausea and vomiting
Sensitivity to light (photophobia)
Blurred or double vision
Seizures
Loss of consciousness
Confusion
Drooping eyelid
Pain above or behind the eye
Dilated pupils
Weakness or numbness in the face, arm, or leg
Causes
The most common cause of SAH is a ruptured brain aneurysm (a weak, bulging spot in a blood vessel). Other causes include:
Traumatic brain injury
Arteriovenous malformation (AVM)
Spinal arteriovenous malformation
Bleeding disorders
Use of blood-thinning medications
Drug use (e.g., cocaine)
In rare cases, SAH can occur without a known cause (nonaneurysmal SAH).
Medicine Used
4. Medicine used Medications used in the treatment of SAH may include:
Nimodipine: A calcium channel blocker used to prevent vasospasm (narrowing of blood vessels) which is a major complication of SAH.
Pain relievers: For headache management.
Antiemetics: To reduce nausea and vomiting.
Anticonvulsants: To prevent or treat seizures.
Antifibrinolytics: Medications such as tranexamic acid can be used to prevent rebleeding before definitive treatment, but carries the risk of increasing ischemic events.
Is Communicable
No, subarachnoid hemorrhage is not communicable or contagious. It is not caused by an infectious agent and cannot be spread from person to person.
Precautions
Precautions following SAH focus on preventing complications and further injury:
Strict bed rest: Initially, to minimize the risk of rebleeding.
Blood pressure management: Maintaining optimal blood pressure to prevent both rebleeding and vasospasm.
DVT prophylaxis: Measures to prevent deep vein thrombosis (blood clots) due to immobility.
Monitor for vasospasm: Close monitoring for signs of vasospasm and prompt treatment if it develops.
Avoiding straining: To prevent increased intracranial pressure.
Following physician's instructions: Adhering to medication schedules and follow-up appointments.
How long does an outbreak last?
SAH is not an outbreak-related disease. It is an acute medical event. There is not an outbreak of the disease. The patient can experience lasting symptoms that are determined from brain damage.
How is it diagnosed?
Diagnosis typically involves:
CT scan: Usually the first imaging test to detect blood in the subarachnoid space.
Lumbar puncture (spinal tap): If the CT scan is negative but SAH is suspected, a lumbar puncture may be performed to look for blood in the cerebrospinal fluid.
Cerebral angiography (CT angiography or conventional angiography): To identify the source of the bleeding, such as an aneurysm or AVM.
MRI: may also be used to confirm diagnosis or detect complications.
Timeline of Symptoms
The onset of symptoms is typically very sudden.
Initial onset: Sudden, severe headache. Other symptoms like stiff neck, nausea, vomiting, and loss of consciousness can occur immediately.
Within hours to days: Symptoms may fluctuate. Vasospasm can develop, leading to new or worsening neurological deficits (weakness, speech problems, etc.). Rebleeding can occur, causing a sudden worsening of symptoms.
Weeks to months: Recovery and rehabilitation. The timeline for improvement varies greatly depending on the severity of the hemorrhage and any resulting brain damage.
Important Considerations
Early diagnosis is critical: Rapid medical attention is essential to improve outcomes.
Vasospasm: A major complication that can cause delayed ischemic stroke.
Rebleeding: A significant risk in the days following the initial hemorrhage.
Hydrocephalus: Can develop as a result of SAH, requiring treatment with a shunt.
Long-term neurological deficits: Patients may experience lasting cognitive, motor, or sensory impairments. Rehabilitation is often necessary.
Psychological impact: SAH can have significant psychological effects on patients and their families.
Follow-up care: Regular follow-up appointments with a neurologist are important for monitoring and managing long-term complications.