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Lahey Health is now part of Beth Israel Lahey Health

by EBSCO Medical Review Board

Definition

A subarachnoid hemorrhage (SAH) is bleeding in the space that surrounds the brain. This can raise pressure around the brain. SAH can be deadly.

Causes

SAH may be caused by:

Risk Factors

SAH is more common in people who are aged 50 years and older. Other things that may raise the risk are:

Symptoms

Problems may be:

  • Sudden, severe headache
  • Nausea and vomiting
  • Stiff neck
  • Light sensitivity
  • Loss of consciousness
  • Seizures

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done. This may be enough to suspect the diagnosis.

Pictures may be taken of the brain and the structures around it. This can be done with:

The fluid in the spine may need to be tested. This can be done with a lumbar puncture.

CT Scan of the Head
Copyright © Nucleus Medical Media, Inc.

Treatment

Emergency care is needed right away. The goals of treatment are to:

  • Stop the bleeding
  • Limit harm to the brain
  • Reduce the risk of another SAH

Options are:

  • Surgery to stop an aneurysm from bleeding
  • Medicines to help blood flow to the brain, to ease pain, and to treat other symptoms, such as seizures

Rehabilitation will be needed when a person is stable. This may include speech, physical, and occupational therapy.

Prevention

SAH cannot always be prevented. To lower the risk:

  • Manage high blood pressure
  • Avoid using tobacco
  • Limit alcohol
  • Eat a healthful diet

RESOURCES

The Brain Aneurysm Foundation  http://www.bafound.org 

National Stroke Association  http://www.stroke.org 

CANADIAN RESOURCES

Brain Injury Canada  http://braininjurycanada.ca 

Heart and Stroke Foundation  http://www.heartandstroke.com 

References

Macdonald RL, Schweizer TA. Spontaneous subarachnoid haemorrhage. Lancet. 2017 Feb 11;389(10069):655-666.

Subarachnoid hemorrhage. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/subarachnoid-hemorrhage. Accessed October 5, 2020.

Revision Information

  • Reviewer: EBSCO Medical Review Board Rimas Lukas, MD
  • Review Date: 09/2020
  • Update Date: 05/25/2021