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Questions and Answers
What is the primary location of bleeding in a subarachnoid hematoma?
What is the most common cause of subarachnoid hematoma?
What is often described as a characteristic symptom of subarachnoid hematoma?
What is the initial diagnostic test for subarachnoid hematoma?
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What is the primary goal of immediate medical attention in subarachnoid hematoma?
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What is often required for patients with subarachnoid hematoma after hospitalization?
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Study Notes
Definition and Pathophysiology
- A subarachnoid hematoma (SAH) is a type of bleeding that occurs in the space between the arachnoid and pia mater, the two innermost layers of the meninges that surround the brain.
- It is a life-threatening condition that can cause rapid neurological deterioration and death.
- SAH occurs when a blood vessel in the brain ruptures, releasing blood into the subarachnoid space.
- The bleeding can cause damage to the brain tissue, leading to cerebral edema, increased intracranial pressure, and potential herniation.
Causes and Risk Factors
- Rupture of an intracranial aneurysm (75-80% of cases)
- Arteriovenous malformations (AVMs)
- Trauma (head injury)
- Blood clotting disorders (e.g., hemophilia)
- Familial predisposition
- Hypertension
- Smoking
- Age (increased risk with age)
Symptoms and Signs
- Sudden and severe headache (often described as the "worst headache of my life")
- Nausea and vomiting
- Confusion and altered mental status
- Seizures
- Focal neurological deficits (e.g., weakness, numbness, or vision changes)
- Neck stiffness and pain
- Photophobia
- Fever
Diagnosis
- Non-contrast CT scan of the head (initial diagnostic test)
- Lumbar puncture (if CT scan is negative or equivocal)
- Cerebral angiography (to identify the source of bleeding)
- MRI (may be used in some cases, but not as sensitive as CT scan)
Treatment and Management
- Immediate medical attention is crucial
- Stabilization of the patient's airway, breathing, and circulation
- Neurointensive care unit (NICU) admission
- Blood pressure control
- Pain management
- Anti-seizure medication
- Surgical or endovascular intervention to secure the aneurysm or AVM
- Rehabilitation and follow-up care after hospitalization
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Description
Learn about the causes, symptoms, diagnosis, and treatment of subarachnoid hemorrhage (SAH), a life-threatening condition that occurs when a blood vessel in the brain ruptures.
