Hemorrhage - subarachnoid
The goals of treatment are to:
Surgery may be done to:
If the patient is critically ill, surgery may have to wait until the person is more stable.
Surgery may involve:
If no aneurysm is found, the person should be closely watched by a health care team and may need more imaging tests.
Treatment for coma or decreased alertness includes:
A person who is is conscious may need to be on strict bed rest. The person will be told to avoid activities that can increase pressure inside the head, including:
Treatment may also include:
How well a patient with subarachnoid hemorrhage does depends on a number of different factors, including:
Older age and more severe symptoms can lead to a poorer outcome.
People can recover completely after treatment, but some people may die even with aggressive treatment.
Repeated bleeding is the most serious complication. If a cerebral aneurysm bleeds for a second time, the outlook is much worse.
Changes in consciousness and alertness due to a subarachnoid hemorrhage may become worse and lead to coma or death.
Other complications include:
Go to the emergency room or call the local emergency number (such as 911) you have symptoms of a subarachnoid hemorrhage.
Selman WR, Hsu D, Tarr RW, Ratcheson RA. Vascular diseases of the nervous system: intracranial aneurysms and subarachnoid hemorrhage. In: Bradley WG, Daroff RB, Fenichel GM, Jankovic J, eds. Neurology in Clinical Practice. 5th ed. Philadelphia, Pa: Butterworth-Heinemann Elsevier; 2008:chap 55C.
Zivin J. Hemorrhagic cerebrovascular disease. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 432.
Reinhardt MR. Subarachnoid hemorrhoid. J Emerg Nurs. 2010;36(4):327-329.
Rabinstein AA, Lanzino G, Wijdicks EF. Multidisciplinary management and emerging therapeutic strategies in aneurysmal subarachnoid hemorrhage. Lancet Neurol. 2010;9(4):504-519.
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