Know the basics

What is subarachnoid hemorrhage?

Subarachnoid hemorrhage (SAH) is sudden bleeding into the space that’s between the brain and the middle membrane covering the brain. Bleeding usually results from the rupture of an abnormal bulge in a blood vessel in your brain (brain aneurysm). It’s very dangerous. Up to 10-15% of people die before reaching the hospital. As many as 40% die in the first week. About half die in the first 6 months. Also, more than one-third of survivors have major neurologic problems.

How common is subarachnoid hemorrhage?

People older than 50 and women have higher risks of SAH. Because finding aneurysms that haven’t burst in people without symptoms is hard, most SAHs cannot be prevented.

Know the symptoms

What are the symptoms of subarachnoid hemorrhage?

The main symptom is a severe headache that starts suddenly (often called thunderclap headache). It is often worse near the back of the head. Many people often describe it as the “worst headache ever” and unlike any other type of headache pain.

Symptoms include:

  • Decreased consciousness and alertness
  • Eye discomfort in bright light (photophobia)
  • Mood and personality changes, including confusion and irritability
  • Muscle aches (especially neck pain and shoulder pain)
  • Nausea and vomiting
  • Numbness in part of the body
  • Seizure
  • Stiff neck
  • Vision problems

There may be some signs or symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Know the causes

What causes subarachnoid hemorrhage?

Subarachnoid hemorrhage can be caused by:

  • Bleeding from a tangle of blood vessels called an arteriovenous malformation (AVM)
  • Bleeding disorder
  • Head injury
  • Unknown cause (idiopathic)
  • Use of blood thinners

In some cases, cause of subarachnoid hemorrhage may be unknown (idiopathic).

Know the risk factors

What increases my risk for subarachnoid hemorrhage?

Certain factors may increase your risk of developing subarachnoid hemorrhage:

  • Aneurysm in other blood vessels
  • Fibromuscular dysplasia (FMD) and other connective tissue disorders
  • High blood pressure
  • History of polycystic kidney disease
  • Smoking
  • A strong family history of aneurysms may also increase your risk.

Understand the diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is subarachnoid hemorrhage diagnosed?

The doctor makes a preliminary diagnosis based on the medical history and physical examination, especially of the nervous system and eyes.

If your doctor thinks you have a subarachnoid hemorrhage, a head CT scan (without contrast dye) will be done right away. In some cases, the scan is normal, especially if there has only been a small bleed. If the CT scan is normal, a lumbar puncture (spinal tap) may be done. Other tests that may be done include:

  • Cerebral angiography of blood vessels of the brain
  • CT scan angiography (using contrast dye)
  • Transcranial Doppler ultrasound, to look at blood flow in the arteries of the brain

Magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) (occasionally)

How is subarachnoid hemorrhage treated?

Treatment aims to reduce pain, swelling, and severity of cerebral vasospasm; relieve nausea and vomiting; prevent seizures and rebleeding; and save lives. Treatment also tries to relieve symptoms and prevent complications such as permanent brain damage (stroke). A medical team is needed.

The doctor may order surgery to repair the aneurysm, remove large collections of blood or relieve pressure on the brain. Surgery may involve craniotomy and endovascular coiling.

Besides, strict bed rest is critical and activities that can increase pressure inside the head (bending over, straining) must be avoided. Drugs include stool softeners or laxatives to prevent straining during bowel movements, blood pressure medicines, pain killers, and drugs for anxiety and seizures. Oxygen and fluids are given.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage subarachnoid hemorrhage?

The following lifestyles and home remedies might help you cope with subarachnoid hemorrhage  :

  • Learn everything you can about your injury. Join a support group if you think that would help.
  • Continue to have follow-up doctor examinations. Follow all your doctor’s instructions. You may also need physical, occupational, and speech therapy.
  • Identify and have proper aneurysm treatment to prevent disease.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.


Review Date: January 4, 2017 | Last Modified: January 4, 2017

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