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Medical condition Subarachnoid hemorrhage Other names Subarachnoid haemorrhage CT scan of the brain showing subarachnoid hemorrhage as a white area in the center (marked by the arrow) and stretching into the sulci to either side Pronunciation / ˌ s ʌ b ə ˈ r æ k n ɔɪ d ˈ h ɛ m ər ɪ dʒ / Specialty Neurosurgery, Neurology Symptoms Severe headache of rapid onset, vomiting, decreased ...
If a rupture or bleeding incident occurs, the blood may penetrate either into the brain tissue (cerebral hemorrhage) or into the subarachnoid space, which is located between the sheaths (meninges) surrounding the brain (subarachnoid hemorrhage). Bleeding may also extend into the ventricular system (intraventricular hemorrhage).
Trauma is the most common cause of intracranial hemorrhage. It can cause epidural hemorrhage, subdural hemorrhage, and subarachnoid hemorrhage. Other condition such as hemorrhagic parenchymal contusion and cerebral microhemorrhages can also be caused by trauma. [3]
Cerebral vasospasm is a common and severe complication following aneurysmal subarachnoid hemorrhage, occurring in 50-90% of cases after aneurysm rupture. Moderate or severe vasospasm in one or more cerebral arteries develops in approximately two-thirds of patients with ruptured aneurysms .
The most common cause of a subarachnoid hemorrhage is an aneurysm rupture due to the weakened blood vessel walls and increased wall stress. [48] The neurologic symptoms are produced by the blood mass effect on neural structures, from the toxic effects of blood on the brain tissue, or by the increasing of intracranial pressure. [49]
Central nervous system (CNS) disorders or conditions may cause SIADH in 9% of cases, this includes subarachnoid hemorrhage (56% of CNS causes), pituitary surgery (35% of CNS causes), brain cancer, infections, stroke and head trauma. [2] No cause of inappropriate antidiuresis is initially found in 17–60% of cases. [2]
Other authors associated hyponatremia in subarachnoid hemorrhage with increased levels of natriuretic peptides, negative sodium balance, and low central venous pressure. [30] [31] [32] A valid diagnosis of "salt wasting" requires evidence of inappropriate urinary salt losses and a reduced "effective arterial blood volume".
The most common cause for bleeding into the subarachnoid space is a subarachnoid hemorrhage from a ruptured cerebral aneurysm. [ 3 ] The most frequently employed initial test for subarachnoid hemorrhage is a computed tomography scan of the head, but it detects only 98% of cases in the first 12 hours after the onset of symptoms, and becomes less ...