Subarachnoid hemorrhage

Subarachnoid hemorrhage - a variant of hemorrhagic stroke, in which blood goes to the brain intershell space.

main feature of hemorrhagic stroke - a rupture of cerebral blood vessel wall and getting into the nervous tissue, subarachnoid (subarachnoid) space in the ventricles of the brain.

Hemorrhagic stroke has two varieties - intracerebral hemorrhage and subarachnoid hemorrhage (SAH), which differ in pathogenesis and symptomatology.


SAH subarachnoid hemorrhage most commonly occurs between the ages of 25-50 years.This is because the rupture of the vessel in this pathology occurs in the majority of cases of congenital aneurysm in place against the background of the situational rise in blood pressure - during physical exertion, emotional stress.Another, more rare cause of SAH can be a vascular malformation rupture.

Risk factors for SAH include smoking, alcohol abuse, cocaine use.CAA can occur against a background of blood disorders such as leukemia, sickle cell anemia, and thrombocytopenia


CAA can occur in tumors of the meninges, cerebral vasculitis.

clinical picture

When an aneurysm or vascular malformation occurrence of neurological symptoms possible before the development of SAH.This is due to a local pressure on the brain vascular formation or cranial nerves.These transient symptoms may be weakness in the arm or leg, double vision.

SAH develops suddenly, with the appearance of a severe headache, which some patients compared with a bang, the other - with the advent of something hot inside the head.

The symptoms are present SAH cerebral symptoms (headache, vomiting, changes in level of consciousness - up to coma, seizures) and meningeal symptoms of irritation of the meninges (the fear of loud noises and light, stiff neck, high morbidity).For small SAH meningeal symptoms may be absent.

Usually NAO is not observed focal symptoms.But it can appear on the 2-3-th week of the disease due to local spasm of the arteries under the influence of a blood clot degradation products.The clinical picture in this case is reminiscent of ischemic stroke with focal symptoms, the relevant affected area.

focal symptoms may occur when large blood clot pressing on the cerebral cortex, or cranial nerves.Pressure may also have an aneurysm or malformation.In both cases, compresses areas of secondary ischemic changes.

Diagnosis and treatment history

addition, aid in the diagnosis of SAH may have a CT scan and MRI of the brain, cerebral angiography.

In identifying vascular disease as a cause of SAH is recommended surgical treatment, for which the patient should be sent to the neurosurgical department.Surgical treatment of SAH is to remove large blood clots, aneurysm clipping, removing vascular malformations.

Conservative treatment of SAH is aimed at the prevention of recurrent hemorrhage, intracranial pressure rise, the development of vasospasm and ischemia of the nervous tissue.

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