Subarachnoid Hemorrhage

by Garreth Myers

The brain is covered by a thin layer of tissue. Between this thin layer of tissue and the brain, there is a small gap which is known as the subarachnoid space. A subarachnoid hemorrhage is a condition in which there is bleeding in the subarachnoid space. This can place pressure on the brain and can lead to a lot of damage to the sensitive brain tissue.


There are several causes of subarachnoid hemorrhage. These include the following:
Arteriovenous malformation: This is usually a genetic condition in which the veins and the arteries in the body are malformed. In such cases, there may be unexplained bleeding in the brain and the subarachnoid space.

  • Bleeding or Clotting Disorders: In case a person suffers from a bleeding or a clotting disorder, they may experience bleeding in the brain. Such bleeding disorders may go unnoticed.
  • Cerebral Aneurysm: A cerebral aneurysm is a weak area in any of the blood vessels in the brain. When the pressure of the blood increases in these veins, these weak areas either leak or balloon up, causing bleeding and even sudden death.
  • Head Injuries: Physical injuries on the head can lead to bleeding in the subarachnoid area. Unattended concussions are often the cause of such bleeding.
  • Blood Thinners: The prolonged use of blood thinners may cause spontaneous bruising and bleeding in many areas of the body.


The first symptom of a subarachnoid hemorrhage is a severe headache. The onset of this kind of headache is usually very sudden. The pain is almost always worse around the back of the head. It is usually very severe, and quite different from the usual types of headache we experience. He/she may also have a popping, splitting or a snapping sensation within the head. Some of the other symptoms of this condition include:

  • Haziness and reduced alertness
  • Decreased consciousness
  • Seizures
  • Pain in the neck and the shoulders
  • Vomiting and nausea
  • Discomfort in the eyes, especially in bright light
  • Numbness in various parts of the body
  • Sudden personality changes
  • Irritability and disorientation
  • Stiffness in the neck and shoulders
  • Double vision, photophobia, temporary loss of vision and even blind spots
  • Differences in pupil size


Since subarachnoid hemorrhage is a life threatening condition, emergency treatment is essential. The treatment is aimed at treating the cause of the bleeding and relieving any life threatening symptoms. Timely subarachnoid hemorrhage treatment will also increase the patient’s chances of avoiding permanent brain damage.

Surgery is the only treatment for subarachnoid hemorrhage. It may be done to repair a leak or aneurysm that is causing the pooling of blood. If there is a large collection of blood, a surgery may be performed to relieve the pressure and prevent brain tissue damage. There are two types of surgeries for this purpose. The first is known as a craniotomy in which a hole is drilled into the skull and the aneurysm is clipped. The second surgery is known as endovascular coiling. This is a treatment in which coils are placed around the aneurysm as this will reduce the risk of leaking and pooling of blood.

After the surgery, medication may be necessary to prevent spasms in the arteries and reduce blood pressure and pressure in the head. Straining during bowel movements increases overall pressure and so the doctor may also recommend stool softeners.


The prognosis of a subarachnoid hemorrhage depends on two main factors. The first is the location and the amount of bleeding in the subarachnoid space. The second is the kind of complications that the hemorrhage causes. A lot of people are able to recover completely after following their treatment course.


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