By Mayo Clinic Staff
Subarachnoid hemorrhage is bleeding in the space between your brain and the surrounding membrane (subarachnoid space). Bleeding usually results from the rupture of an abnormal bulge in a blood vessel in your brain (brain aneurysm).
Sometimes an abnormal tangle of blood vessels in your brain (arteriovenous malformation), trauma or other events cause bleeding. A subarachnoid hemorrhage may lead to permanent brain damage or death if not treated.
- Experience and expertise. Mayo Clinic doctors trained in brain and nervous system surgery (neurosurgery), brain and nervous system conditions (neurology), brain imaging (neuroradiology), physical medicine and rehabilitation and other areas diagnose and treat more than 500 people with subarachnoid hemorrhage annually.
- Team approach. Mayo Clinic doctors trained in neurosurgery, neurology, neuroradiology, physical medicine and rehabilitation, and other areas work together to evaluate your condition and determine the most appropriate treatment.
- Technology. Mayo Clinic doctors use advanced imaging tests to diagnose your condition and develop your treatment plan.
- Efficient system. Mayo Clinic doctors evaluate your condition and develop a treatment plan in days, not weeks.
- Research. Mayo Clinic doctors study the risks, causes, prevention, and new diagnosis and treatment options for subarachnoid hemorrhage and other neurological conditions and conduct clinical trials.
Mayo Clinic in Rochester, Minn., ranks No. 1 for neurology and neurosurgery in the U.S. News & World Report Best Hospitals rankings. Mayo Clinic in Scottsdale, Ariz., and Mayo Clinic in Jacksonville, Fla., are ranked among the Best Hospitals for neurology and neurosurgery by U.S. News & World Report.
Mayo Clinic doctors trained in brain and nervous system surgery (neurosurgery), brain and nervous system conditions (neurology), brain imaging (neuroradiology), physical medicine and rehabilitation and other areas work as a team to diagnose subarachnoid hemorrhage, determine the cause of your condition and quickly develop the most appropriate treatment plan for you.
To diagnose your condition, your doctor may evaluate your symptoms, including any unexpected, severe headaches. Your doctor may order tests to diagnose and determine the cause of your condition.
Computerized tomography (CT) scan. A CT scan uses a series of X-rays to create detailed cross-sectional images of your brain and blood vessels. CT scans can help detect bleeding in your brain.
Your doctor may inject a contrast dye to view your blood vessels in greater detail (CT angiogram).
Magnetic resonance imaging (MRI). An MRI uses powerful magnetic fields and radio waves to create detailed images of your brain and blood vessels. An MRI can help detect bleeding in your brain and may help determine the underlying cause for the bleeding.
Your doctor may inject a dye into a blood vessel to view your blood vessels and show the blood circulation in your brain (magnetic resonance angiogram).
Lumbar puncture. If your doctor suspects a subarachnoid hemorrhage but the hemorrhage doesn't appear on a CT scan, your doctor may order a lumbar puncture.
In this test, a doctor will insert a needle into your lower back to withdraw a small amount of fluid that surrounds your brain and spinal cord (cerebrospinal fluid). Your doctor will examine the cerebrospinal fluid for the presence of blood.
- Cerebral angiography. In this test, a doctor inserts a long, thin tube (catheter) into an artery in your leg and threads it to your brain. A doctor injects dye into the blood vessels of your brain to make them visible under X-ray imaging.
Read more about CT scan, MRI and lumbar puncture.
Mayo Clinic doctors trained in brain and nervous system surgery (neurosurgeons), brain and nervous system conditions (neurologists), brain imaging (neuroradiologists), physical medicine and rehabilitation and other areas work together to provide your care.
Your treatment team will work with you to quickly develop an individualized treatment plan for you. Your treatment is based on the cause and severity of your condition.
Mayo Clinic staff trained in neurological critical care provides your treatment in the intensive care unit and closely monitors you to stabilize your condition.
The staff treats your symptoms and detects and manages any complications you may experience, including rebleeding, narrowed brain blood vessels limiting blood flow (cerebral vasospasm), buildup of fluid in your brain (hydrocephalus) or other complications.
Doctors will treat the cause of your subarachnoid hemorrhage, including arteriovenous malformations, trauma, brain aneurysm or other causes. Depending on the cause of your condition, you may need surgery or other treatment.
If your subarachnoid hemorrhage is caused by a ruptured brain aneurysm, you may need surgery or an endovascular procedure.
- Surgery. During the surgery, done under general anesthesia, your surgeon makes an incision in your scalp, creates a window in your skull, locates the brain aneurysm and places a metal clip across its neck to stop blood flow to the aneurysm.
Endovascular embolization. In this procedure, a doctor inserts a long, thin tube (catheter) into an artery in your groin and guides it to your brain using X-ray imaging.
Your neuroradiologist or neurosurgeon then guides detachable platinum coils through the catheter, placing the coils in the aneurysm (aneurysm coiling). The coils fill the aneurysm, which reduces blood flow into the aneurysm sac and causes the blood to clot. Your surgeon also may insert a balloon or tube (stent) in the artery to keep it open and then perform the aneurysm coiling.
Endovascular procedures sometimes need to be performed again. You'll have regular follow-up appointments with your doctor to watch for any changes.
Doctors will monitor your condition for any changes or complications while you're in the intensive care unit and during regular follow-up appointments. You may also need physical, occupational and speech therapy.
Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people. In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.
Doctors trained in neurosurgery, neuroradiology, vascular neurology, and physical medicine and rehabilitation diagnose and treat subarachnoid hemorrhage at Mayo Clinic.
For appointments or more information, call the Central Appointment Office at 800-446-2279 (toll-free) 8 a.m. to 5 p.m. Mountain Standard Time, Monday through Friday or complete an online appointment request form.
- U.S. Patients
- International Patients
Doctors trained in neurosurgery, neurology, neuroradiology, and physical medicine and rehabilitation diagnose and treat subarachnoid hemorrhage at Mayo Clinic.
For appointments or more information, call the Central Appointment Office at 904-953-0853 8 a.m. to 5 p.m. Eastern time, Monday through Friday or complete an online appointment request form.
- U.S. Patients
- International Patients
Doctors trained in neurosurgery, cerebrovascular diseases and neurological critical care, neuroradiology, and physical medicine and rehabilitation diagnose and treat subarachnoid hemorrhage at Mayo Clinic.
For appointments or more information, call the Central Appointment Office at 507-538-3270 7 a.m. to 6 p.m. Central time, Monday through Friday or complete an online appointment request form.
- U.S. Patients
- International Patients
See information on patient services at the three Mayo Clinic locations, including transportation options and lodging.
Mayo Clinic doctors trained in brain and nervous system surgery (neurosurgery), brain and nervous system conditions (neurology) and other areas study laboratory and clinical research in prevention, causes, diagnosis and treatment options for subarachnoid hemorrhages.
Read more about research in neurosurgery and neurology.
See a list of publications by Mayo doctors on subarachnoid hemorrhages at PubMed, a service of the National Library of Medicine.
- Maria I. Aguilar, M.D.
- Kevin M. Barrett, M.D.
- Thomas G. Brott, M.D.
- Robert D. Brown Jr., M.D.
- Brian W. Chong, M.D.
- Kelly D. Flemming, M.D.
- William D. Freeman, M.D.
- Jimmy R. Fulgham, M.D.
- David F. Kallmes, M.D.
- Giuseppe Lanzino, M.D.
- Michael J. Link, M.D.
- Irene Meissner, M.D.
- James F. Meschia, M.D.
- Fredric B. Meyer, M.D.
- George W. Petty, M.D.
- Alejandro A. Rabinstein, M.D.
- Eelco F.Wijdicks, M.D., Ph.D.
Aug. 19, 2014
- Ferri FF. Ferri's Clinical Advisor 2014: 5 Books in 1. Philadelphia, Pa.: Mosby Elsevier; 2014. https://www.clinicalkey.com. Accessed July 7, 2014.
- Choi KS, et al. Therapeutic and prognostic implications of subarachnoid hemorrhage in patients who suffered cardiopulmonary arrest and underwent cardiopulmonary resuscitation during an emergency room stay. Clinical Neurology and Neurosurgery. 2013;115:2088.
- Cerebral aneurysm fact sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/cerebral_aneurysm/detail_cerebral_aneurysms.htm. Accessed July 7, 2014.
- Connolly ES, et al. Guidelines for the management of aneurysmal subarachnoid hemorrhage: A guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2012;43:1711.
- Riggin EA. Decision Support System. Mayo Clinic, Rochester, Minn. June 12, 2014.