What Happens in Bleeding Under the Brain Membranes (Subarachnoid Hemorrhage)?
In this type of bleeding, there is a rupture in one of the large arteries at the base of the brain. In this case, the leaking blood spreads around the entire brain and also into the cerebrospinal fluid. Most subarachnoid hemorrhages are caused by the rupture of an aneurysm (that is, a vascular ballooning) already present in the brain. The walls of these aneurysms are thin and therefore prone to rupture. Some people have aneurysms from birth, but these may never rupture throughout life. However, the consequences of aneurysm rupture are generally very serious. Approximately half of the patients with a bleeding aneurysm are lost.
Contents
- What Happens in Bleeding Under the Brain Membranes (Subarachnoid Hemorrhage)?
- Who Is More Likely to Have Subarachnoid Hemorrhage?
- What Are the Signs and Symptoms of Subarachnoid Hemorrhage?
- How Is It Determined with Certainty That a Brain Hemorrhage Has Occurred?
- Brain Aneurysm (Vascular Ballooning)
- Treatment of Brain Hemorrhage Due to Brain Aneurysm
Who Is More Likely to Have Subarachnoid Hemorrhage?
Although the frequency of brain aneurysms in the population is between 5% and 10%, this type of hemorrhage is generally seen in 1 out of 10,000 people. It is more commonly seen in the 20–60 age group. It is seen slightly more often in women than in men.
What Are the Signs and Symptoms of Subarachnoid Hemorrhage?
The most common finding is a sudden-onset headache. This headache is generally described as “the worst pain experience ever.” Nausea and vomiting may also accompany the headache. In addition, confusion, decreased attention, and disorders of consciousness that may gradually progress to coma can be seen. Visual disturbances, double vision, blind spots in vision, or sudden vision loss in one eye may also occur. The neck is painful and stiff. Light may disturb the eyes. The person may have a seizure. A part of the body may become immobile.
How Is It Determined with Certainty That a Brain Hemorrhage Has Occurred?
As a result of the examination, neck stiffness and the presence of neurological disorders in various parts of the body help to diagnose brain hemorrhage. Bleeding in the subarachnoid area is also seen on brain tomography or MRI examination. In addition, aneurysms or other vascular abnormalities can be demonstrated with angiography of the brain vessels, and the exact location of the bleeding can be determined.
Brain Aneurysm (Vascular Ballooning)
Ballooning that occurs in a vessel due to weakness in the muscle layer inside one of the brain vessels is called a brain aneurysm. This ballooning causes thinning and weakening of the vessel wall. The intracranial bleeding that occurs as a result of rupture at this weakened point of the vessel is called subarachnoid hemorrhage. This type of bleeding may lead to stroke, coma, or death.
Treatment of Brain Hemorrhage Due to Brain Aneurysm
Painkillers and medications that reduce tension may be used to relieve headache. If blood pressure is very high, appropriate medications may be used to regulate it. If the patient is having seizures, appropriate medications may be used to prevent them. Surgical treatment is generally needed. This may be done either through aneurysm clipping surgery performed by opening the skull via craniotomy, or through an endovascular procedure performed by sending a platinum coil into the brain using one of the groin arteries. Surgical intervention may also be required to remove a large amount of bleeding that has developed inside the brain.
