Subarachnoid Hemorrhage – Quick Guide

A subarachnoid hemorrhage (SAH) is a type of brain bleed that happens in the space between the brain and the thin membranes covering it. It’s not common, but when it strikes, time matters. Knowing what to look for and how to act can save lives.

How to Spot a Subarachnoid Hemorrhage

The first sign is often a sudden, severe headache that feels like “the worst headache of my life.” People describe it as a thunderclap – a sharp, explosive pain that hits fast. Other red flags include:

• Nausea or vomiting without an obvious reason.
• Stiff neck that makes turning your head painful.
• Blurred vision, double vision, or a brief loss of consciousness.
• Sensitivity to light (photophobia) and confusion.

If you or someone nearby experiences any of these symptoms out of the blue, call emergency services right away. Even if the pain eases later, it doesn’t mean the bleed stopped – doctors still need to check.

Immediate Steps & Treatment Options

The moment EMS arrives, they’ll monitor your vitals and try to keep blood pressure stable. High blood pressure can worsen the bleeding, so paramedics often give medication to lower it gently.

In the hospital, a CT scan is usually the first test because it spots fresh blood fast. If the scan is unclear but suspicion stays high, doctors may do a lumbar puncture (spinal tap) to look for blood in the spinal fluid.

Treatment focuses on three goals:

1. Stop the bleeding. This might involve surgery called clipping, where a tiny metal clip seals the ruptured aneurysm, or endovascular coiling, where doctors thread a coil through a catheter to block the blood flow.
2. Prevent re‑bleeding. Blood pressure control, calcium channel blockers like nimodipine, and careful fluid management help keep the brain safe.
3. Manage complications. Brain swelling, hydrocephalus (fluid buildup), and vasospasm (vessel narrowing) are common. Monitoring in an intensive care unit lets doctors treat these issues quickly.

Recovery can take weeks to months. Physical therapy, speech therapy, and cognitive rehab are often needed because SAH can affect memory, speech, and coordination. Family support makes a huge difference – simple encouragement and helping with daily tasks go a long way.

Preventing an SAH starts with managing risk factors. Keep blood pressure in check through diet, exercise, and medication if prescribed. If you have a family history of brain aneurysms, talk to your doctor about screening tests like MR angiography.

In short, recognize the thunderclap headache, act fast, and get to a hospital where imaging and specialist care can start right away. Early treatment dramatically improves outcomes, turning a scary emergency into a manageable medical event.