Subarachnoid Hemorrhage

Overview

Subarachnoid hemorrhage — bleeding that occurs in the space between the surface of the brain and the skull — can cause strokes or seizures and may lead to permanent brain damage or death.

At Mayo Clinic, world-renowned specialists from neurosurgery, neuroradiology and a rehabilitation team with neuro-intensive care unit professionals and subspecialty nurses work together to determine and deliver the most appropriate treatment to patients with subarachnoid hemorrhages.

Mayo's superb magnetic resonance angiography (MRA), computed tomography angiography (CTA) and 3-D angiogram imaging capabilities allow specialists to confirm the diagnosis and quickly determine the most appropriate treatment. Outcomes that may take weeks to accomplish in other settings can be achieved quickly through Mayo's combination of teamwork and innovative diagnostic tools.

Neurology and Neurosurgery at Mayo Clinic in Rochester, Minnesota is ranked No. 1 in U.S. News & World Report's listing of America's best hospitals since 1994.

Diagnosis

Subarachnoid hemorrhages may be traumatic, resulting from an injury or other trauma, or spontaneous (non-traumatic), developing without apparent cause. Non-traumatic subarachnoid hemorrhages are relatively uncommon, affecting one in 10,000 people in the United States annually.

An estimated 10 percent of subarachnoid hemorrhages result in sudden death. An additional 10 percent to 20 percent of patients are comatose or require respiratory support on arriving at the emergency department. As a result, diagnosis can be difficult.

At Mayo Clinic, teams of specialists work together to confirm the correct diagnosis and provide the aggressive care and treatment required for subarachnoid hemorrhages. Rapid admission to Mayo's neuro-intensive care unit may increase the likelihood that the patient's condition will stabilize and reduce the risk of recurrent hemorrhage and other complications.

Learn about subarachnoid hemorrhage diagnosis.

Treatment

Treatment for subarachnoid hemorrhage is based on the underlying cause of the hemorrhage and the extent of damage to the brain. Depending on the severity of the hemorrhage, treatment may include lifesaving measures, symptom relief and repair of what is causing the bleeding.

At Mayo, neuro-intensive care unit professionals focus on minimizing the damage, stabilizing the patient, introducing lifesaving measures (if necessary) and providing symptom relief. Mayo's system involves specialists who work together to detect complications, prevent further bleeding and determine the most effective treatment.

Mayo Clinic's excellent diagnostic tools and aggressive research about subarachnoid hemorrhage allow specialists to confirm the diagnosis, detect any complications and quickly determine the most appropriate treatment for each patient.

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About Subarachnoid Hemorrhage

Spontaneous (non-traumatic) subarachnoid hemorrhage typically occurs due to the rupture of an aneurysm (an abnormal bulging of a blood vessel in the brain) or bleeding from malformed blood vessels in the brain.

Brain aneurysms are likely present in one of every 100 to 200 people. Each year 6 million people in the U.S. have aneurysms, but only a small percentage of those aneurysms will hemorrhage. Many small aneurysms that have not caused symptoms are identified by chance on brain scans performed for unrelated conditions. They often do not require treatment.

Subarachnoid hemorrhage may also be caused by trauma due to an accident or fall. For those patients, the subarachnoid hemorrhage is part of other manifestations of the brain injury and may be treated differently due to other considerations.

Thunderclap headache

Patients with subarachnoid hemorrhage may have symptoms ranging from the most serious — being comatose — to relatively less serious, such as a very sudden, severe headache (with or without associated confusion) and diminished alertness. A subarachnoid hemorrhage headache is often referred to as thunderclap headache. It is crucial that patients with subarachnoid hemorrhages receive treatment as quickly as possible.