Subarachnoid hemorrhage — what to know now
A sudden, explosive headache that feels like the worst of your life can mean a subarachnoid hemorrhage (SAH). This type of brain bleed fills the space around the brain with blood and often comes on without warning. When SAH happens, time matters — early action can save lives and reduce long-term damage.
Causes & common signs
The most frequent cause is a ruptured aneurysm — a weak spot in a brain artery that bursts. Head trauma, arteriovenous malformations (AVMs), and rare bleeding disorders can also cause SAH. Typical warning signs are a sudden, severe "thunderclap" headache, neck stiffness, nausea or vomiting, light sensitivity, drowsiness, and sometimes loss of consciousness. You might also notice weakness, speech trouble, or confusion if bleeding affects certain brain areas.
Not everyone has obvious signs at first. If you or someone else reports a rapid, intense headache unlike any before, treat it as an emergency until proven otherwise.
Triage, tests and immediate steps
Call emergency services right away. Paramedics and ER teams prioritize quick imaging and stabilization. In the hospital, a non-contrast CT scan is the first test; it finds most SAH cases within the first 6–24 hours. If the CT is unclear but suspicion stays high, doctors may do a lumbar puncture (spinal tap) to check for blood in the cerebrospinal fluid, and vascular imaging (CTA or digital subtraction angiography) to locate an aneurysm or other bleeding source.
Do not give aspirin, warfarin, or other blood thinners unless directed by a doctor. Try to keep the person calm and still, and avoid heavy lifting or straining while waiting for help.
Treatment focuses on stopping the bleeding source and preventing complications. Neurosurgeons or interventional radiologists may clip an aneurysm or seal it with endovascular coiling. ICU care manages blood pressure, prevents re-bleeding, treats hydrocephalus (excess fluid in the brain) with a drain if needed, and uses medications like nimodipine to lower the risk of delayed brain vessel spasms.
Complications such as vasospasm, delayed ischemia, rebleeding, and hydrocephalus are common reasons patients need close monitoring for days to weeks. Rehab services — physical, speech, and occupational therapy — often start in the hospital and continue after discharge.
Can SAH be prevented? You can lower risk by controlling high blood pressure, quitting smoking, and treating known aneurysms when your doctor recommends it. If you have a family history of brain aneurysms, ask your doctor about screening.
If you get a sudden severe headache, fainting, weakness, or vomiting with neck pain — don’t wait. Call emergency services now. Early hospital care gives the best chance for survival and recovery.
Subarachnoid Hemorrhage and Pregnancy: What Expectant Mothers Need to Know
Alright, my lovely expectant ladies, let's dive into the deep end of the pool and chat about Subarachnoid Hemorrhage during pregnancy. No need to panic, it's just a fancy term for bleeding in the brain, which sounds scary, but is actually pretty rare. Still, it's good to have on your radar, just like those midnight ice cream cravings! It can cause severe headaches, neck pain or even loss of consciousness. So, keep those doctor's appointments and don't forget to ask about anything unusual, even if it's just a simple headache. After all, better safe than sorry, right?
1.08.23
Alistair Mukondiwa
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