Subarachnoid hemorrhage

21:54 - 4 May , 2021

Disease

What is Subarachnoid hemorrhage?

It is abrupt bleeding in the subarachnoid space, which is the brain area that contains the cerebrospinal fluid, located between the pia mater and the arachnoid. It is a serious condition that can cause serious disability in the patient or even death, being a type of stroke whose incidence is more common in women. If there is a malformation or weakness in the brain blood vessels or they experience excessive pressure, it is possible that a hemorrhagic cerebrovascular accident, also known as a stroke, can cause intracerebral or middle zone bleeding, that is, in the subarachnoid space. This type of hemorrhage can occur in people of any age but is more frequent after turning 40. It is considered a cerebrovascular accident when it appears suddenly due to the rupture of a cerebral aneurysm, either congenital or as a consequence of uncontrolled hypertension.

Symptoms

Regularly, before its rupture, an aneurysm does not cause symptoms, but if it does, it usually causes the following which constitutes a warning signal:
  • Double vision.
  • Intense and abrupt headache whose nature is unlike any other that has been experienced.
Once the aneurysm ruptures, the symptoms are:
  • Intense and sudden headache whose effect can be described as thunder passing through the head.
  • Sore face and eyes.
  • Double vision.
  • Vomit.
  • Dizziness.
  • Low back pain.
  • Blurred vision.
  • Stiff neck.
  • Fainting.
  • Heart rate involvement.
  • Breathing problems.
  • Seizures.
When a subarachnoid hemorrhage occurs, complications such as:
  • Hydrocephalus due to accumulation of blood and cerebrospinal fluid that significantly increases intracranial pressure.
  • Constriction of cerebral blood vessels or vasospasm that decreases blood flow.
  • New ruptured aneurysms.

Diagnosis and treatment

As it is a medical emergency, the patient will undergo a CT or MRI to identify and locate the hemorrhage, although if the results are not definitive, a lumbar puncture or cerebral angiography is indicated. The treatment to follow consists of painkillers and anti-inflammatories that do not have an anticoagulant effect, laxatives, and calcium blockers. Likewise, it is essential to control arterial and intracranial pressure to avoid new ruptures. Aneurysm repair is performed through endovascular surgeries such as:
  • Endovascular coiling.
  • Endovascular stent.
At the Neurological Center, a select group of highly trained and certified doctors in various neurological specialties are ready to assist you with the quality and warmth that characterizes us. Nervous system specialties
  • Neurology
  • Neurosurgery
  • Spine surgery
  • Pediatric neurosurgery
  • Neurophysiology
  • Neuro-rehabilitation
  • Neuro-pathology
  • Interventional neuro-radiology
  • Neuropsychology
  • Neuro-oncology
  • Neuro-otology
  • Epilepsy
  • Neuro-ophthalmology
  • Neuroimaging

Fuentes:

  • topdoctors.es
  • elsevier.es
  • mayocilinic.org
  • medlineplus.gov
  • msdmanuals.com
  • medigraphic.com
  • Galofre-Martínez MC, Ordosgoitia-Morales J, Ripoll-Zapata V, et al. Manejo neurointensivo de la hemorragia subaracnoidea aneurismática. Rev Cub Med Int Emerg. 2020;19(3):1-23.
  • Amaya DLIO, González RSE, Díaz AFA, et al. Hemorragia subaracnoidea en paciente con neumonía grave por COVID-19, secundario a coagulación intravascular diseminada. Med Crit. 2021;35(4):216-219. doi:10.35366/101161.
  • Brenes ZMJ, Romero CA, Jiménez VM. Abordaje de hemorragia subaracnoidea. Revista Médica Sinergia. 2020;5(10):1-12.
  • Gloria EJM, Zuluaga GJP, Duque GL, et al. Anomalías electrocardiográficas en hemorragia subaracnoidea. Cardiovasc Metab Sci. 2019;30(4):136-142.

						
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