Subarachnoid hemorrhage

(SAH)

 

 

Definition: Blood escaping (extravasating) from an artery on the surface of the brain can fill the subarachnoid space and cause serious neurologic deficits due to mass effect, vasospasm, seizures, etc.

 

Release of atrial natriuretic factor can lead to hyponatremia.

 

 

Subarachnoid hemorrhages can be classified as those resulting from:

 

1. spontaneous rupture of a cerebral or spinal vascular malformation in continuity with the subarachnoid space

 

2. traumatic rupture of cerebral or spinal vascular malformation in continuity with the subarachnoid space

 

Seizures

When cerebral aneurysms rupture blood fills the subarachnoid space that surrounds the brain.  The blood around the brain can be very irritating to the brain surface (cortex) which can cause seizures.  However, after a few days to weeks the blood breaks down and dissolves and the irritation of the brain surface resolves. 

Vasospasm is a common complication of subarachnoid bleeding that can cause a stroke.  Areas of stroke can be prone to seizures.

Unless there has been permanent injury to the brain surface (a stroke) the risk of future seizures long term following subarachnoid hemorrhage is low.

 

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Hemorrhage

 

 

compare Intraventricular hemorrhage

compare Intracerebral hemorrhage

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Spontaneous subarachnoid hemorrhage

 

 

Spontaneous subarachnoid hemorrhage -- pathophysiology

 

Spontaneous subarachnoid hemorrhage - presentation

 

Spontaneous subarachnoid hemorrhage - workup

 

Clipping of cerebral aneurysm - procedure

 

Clipping of cerebral aneurysm - risks and complications

 

 

Stroke and Cerebrovascular Specialty Center

 

 

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Traumatic subarachnoid hemorrhage

 

 

Traumatic subarachnoid hemorrhage -- pathophysiology

 

 

Traumatic intracranial hematoma

 

 

 

Neuro Trauma Specialty Center

 

 

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Figure: Blood fills the subarachnoid space over the right hemisphere of the brain.  The blood is thickest where it fills sulci and thinnest over gyri.

 Gregory Pinsky MD USC Neuropathology

Figure: Blood fills the subarachnoid space at craniotomy for aneurysm clipping.

A Kim MD USC Neurosurgery

figure: subarachnoid hemorrhage CT head

[compare: normal head CT]

 

 

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