Subarachnoid hemorrhage (brain bleeding)

Description The subarachnoid sp...

Description

The subarachnoid space covers the brain and spinal cord. A subarachnoid hemorrhage (SAH) occurs when there is bleeding into this space. A subarachnoid hemorrhage can be life threatening. The most common cause of bleeding is a rupture of an aneurysm. An aneurysm is a focal area of swelling of an artery in the brain. An aneurysm can be congenital (present from time of birth) and may not cause any symptoms unless it bleeds. A tendency to form aneurysms can be an inherited trait. Other causes of SAH include head trauma and arteriovenous malformation (AVM, a tangle of veins and arteries that is a variation of normal anatomy and is prone to rupture).

Symptoms

Sudden onset of severe headache, a popping or snapping sensation is sometimes described, the headache is described as the worst of one's life, vomiting, fainting, weakness, confusion, seizure, coma.

Tests

Common tests used for diagnosis and treatment

Workup:
A history and physical exam will be performed. Tests to establish the diagnosis and determine the cause will be done. If the initial head CT is normal a lumbar puncture (spinal tap) may be performed to rule out a small bleed.

Tests:
Complete blood count (CBC), Comprehensive metabolic panel (CMP), CT Scan, Electrocardiogram (EKG), Magnetic resonance imaging (MRI), X-ray

Other Specific Tests: Cerebral angiogram, CTA of head, MRA of head, lumbar puncture

Specialists:
Neurosurgery, Vascular and Interventional Radiology

Treatment

The goals of therapy are repair the cause of bleeding, relieve symptoms, and prevent complications. Specific treatments depend on the cause of the bleeding. For aneurysms surgical clipping and endovascular clotting off of the aneurysm are the most common procedures. Any associated bleeding abnormalities will be reversed as well as blood pressure control