Subarachnoid hemorrhage

Alternative names:

hemorrhage - subarachnoid

Treatment:

Treatment goals include lifesaving measures, relief of symptoms, repair of the cause of the bleeding, and prevention of complications.

Treatment for coma or decreased mental status may be required, including positioning, airway protection, and life support.

If a person is conscious, strict bedrest may be advised, accompanied by measures to avoid increase in intracranial pressure (pressure in the head). This may include avoiding activities such as bending over, straining, lying flat, sudden position changes, or similar activities.

Stool softeners or laxatives may prevent straining during bowel excretion.

Analgesics and anti-anxiety medications may be used to relieve headache and reduce intracranial pressure. Antihypertensive medications may be used to moderately reduce blood pressure if it is very high. Phenytoin or other medications may be used to prevent or treat seizures. Nimodipine (a calcium channel blocker) is almost always used to prevent vasospasm (spasm of a blood vessel).

Surgical repair is usually required. This may also include surgical removal of large collections of blood. (See Craniotomy.)

Expectations (prognosis):

Subarachnoid hemorrhage has a variable prognosis (probable outcome) depending on the location and extent of the bleeding and complications. Complete recovery can occur after treatment, but death may occur in some cases with or without treatment.

Complications:

• stroke
• seizures
• side effects of medications (see the specific medication)
• complications of surgery

Calling your health care provider:

Go to the emergency room or call the local emergency number (such as 911) if symptoms of subarachnoid hemorrhage are present. Emergency symptoms include seizures or breathing difficulties; loss of consciousness; difficulties with speech, vision, movement, or sensation; and eating or swallowing difficulties.