Subarachnoid Hemorrhage

Treatment

Mayo Clinic doctors trained in brain and nervous system surgery (neurosurgeons), brain and nervous system conditions (neurologists), brain imaging (neuroradiologists), 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.

Staff trained in neurological critical care provides your treatment in the intensive care unit. The staff closely monitors you to stabilize your condition. The staff treats your symptoms and detects and manages any complications you may experience, including re-bleeding, 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 also may need physical, occupational and speech therapy.