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What Is Traumatic Subarachnoid Hemorrhage?

Brain injuries are a leading cause of motor vehicle accident-related deaths. According to the Centers for Disease Control and Prevention:

  • In the U.S., 1.7 million people sustain a TBI each year. Of these, 52,000 lose their lives and 275,000 require hospitalization.
  • Emergency departments treat and release around 80% of people who sustain a TBI.
  • TBI is a contributing factor in about 33% of all injury-related deaths in this country.

It’s unfortunate that so many sufferers of TBI report to the ER for treat-and-release since many symptoms of a TBI don’t fully manifest until hours or even days after the incident. An example of this is a rare but serious complication called traumatic subarachnoid hemorrhage.

What Is Traumatic Subarachnoid Hemorrhage?

A subarachnoid hemorrhage (SAH) is when there’s bleeding into the space between the surface of the brain and one of its coverings (arachnoid). This space is usually filled with cerebrospinal fluid, and bleeding usually occurs when small arteries in the area tear, causing widespread detrimental effects. Trauma is the leading cause of spontaneous SAH, though the majority of Traumatic SAH (tSAH) is due to ruptured brain aneurysm.

Though tSAHs can be devastating, they’re relatively rare. The incidence rate in North America is only about 28 in 100,000.

Risk Factors for tSAH

Any traumatic head injury will increase your risk for SAH, but there are a few other factors that play a role, including:

  • High blood pressure
  • Smoking
  • Using oral contraceptives
  • Pregnancy
  • Cocaine abuse

A SAH also occurs in 20–40% of people who sustain a moderate or severe head injury.

Symptoms of SAH

Most people with tSAH reported a headache of sudden and severe onset. These patients will describe it as “the worst headache of their lives,” and patients report this symptom in approximately 97% of cases. Other symptoms include nausea, vomiting, loss of consciousness, blurry vision, and neck stiffness.

Diagnosis and Treatment

If you or a loved one experience any of the above symptoms, seek immediate emergency medical care. Doctors will likely order a CT scan to detect the presence of bleeding in the brain. In some cases, patients may require a lumbar puncture. Once your doctors determine the cause and location of the bleeding, they’ll immediately begin treatment. This depends largely on the underlying cause of the injury, but it may include surgery to stop the bleeding and preserving vital organ health and function.

Outcomes for tSAH

Medical technology has done a lot to help patients who suffer from traumatic subarachnoid hemorrhage. Despite medical breakthroughs, however, about 33–50% of patients who sustain this type of brain bleed will die or be left with declined brain function. A patient’s prognosis depends on how bad the initial bleed was, how soon it was treated, and which complications develop.

No two head injuries are exactly the same. All patients recover at different rates and to varying degrees. Recovery from head injury follows a particular process, but the rate at which a patient progresses through the process varies by individual. Helping a loved one through a tSAH takes time and patience, as recovery from these injuries can take months or even years.

What You Can Do

If your loved one is struggling with the side effects of a subarachnoid hemorrhage, you may feel helpless. This is normal. Remember, you’re not alone. If loved ones are resting or in a coma, be by their side, hold their hand, and talk to them. Even if they’re not responding, they may be able to hear and understand you. If you have any other questions about subarachnoid treatment or rehabilitation, talk to your loved one’s health care provider.

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