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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 treatment is not received, this bleeding can cause long-term problems such retinal detachment or scarring in addition to impairing eyesight. The underlying pathology originates in the brain and usually involves an intracranial hemorrhage, such as a subarachnoid hemorrhage (SAH), or several types of elevated intracranial pressure.
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 .
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]
Currently there are two treatment options for securing intracranial aneurysms: surgical clipping or endovascular coiling. If possible, either surgical clipping or endovascular coiling is typically performed within the first 24 hours after bleeding to occlude the ruptured aneurysm and reduce the risk of recurrent hemorrhage. [31]
Although the pathophysiology of CSWS is not fully understood, it is usually caused by neurological injury, most commonly aneurysmal subarachnoid hemorrhage. [5] It is also reported after surgery for pituitary tumor, acoustic neuroma, calvarial remodeling, glioma and with infections including tuberculous meningitis, viral meningitis, metastatic carcinoma, and cranial trauma.
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 .
In subarachnoid hemorrhage, early treatment for underlying cerebral aneurysms may reduce the risk of further hemorrhages. Depending on the site of the aneurysm this may be by surgery that involves opening the skull or endovascularly (through the blood vessels).