Treatment:

The goals of treatment are to:

• Save your life
• Repair the cause of bleeding
• Relieve symptoms
• Prevent complications such as permanent brain damage (stroke)

Surgery may be done to:

• Remove large collections of blood or relieve pressure on the brain if the hemorrhage is due to an injury
• Repair the aneurysm if the hemorrhage is due to an aneurysm rupture

If the patient is critically ill, surgery may have to wait until the person is more stable.

Surgery may involve:

• Craniotomy (cutting a hole in the skull) and aneurysm clipping -- to close the aneurysm
• Endovascular coiling -- placing coils in the aneurysm to reduce the risk of further bleeding

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:

• Draining tube placed in the brain to relieve pressure
• Life support
• Methods to protect the airway
• Special positioning

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:

• Bending over
• Straining
• Suddenly changing position

Treatment may also include:

• Medicines given through an IV line to control blood pressure
• Nimodipine to prevent artery spams
• Painkillers and anti-anxiety medications to relieve headache and reduce pressure in the skull
• Phenytoin or other medications to prevent or treat seizures
• Stool softeners or laxatives to prevent straining during bowel movements

Expectations (prognosis):

How well a patient with subarachnoid hemorrhage does depends on a number of different factors, including:

• Location and amount of bleeding
• Complications

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.

Complications:

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:

• Complications of surgery
• Medication side effects
• Seizures
• Stroke

Calling your health care provider:

Go to the emergency room or call the local emergency number (such as 911) you have symptoms of a subarachnoid hemorrhage.