Subarachnoid Haemorrhage - Diagnosis & Treatment

Symptoms & Causes Diagnosis & Treatment

How is a subarachnoid haemorrhage diagnosed?

Diagnosing a subarachnoid haemorrhage involves several steps:

Physical examination. Neurological assessment to identify signs of SAH.
Imaging tests
- CT Scan (Computed Tomography) and CT Angiogram. Quickly identifies bleeding in the subarachnoid space.
- MRI (Magnetic Resonance Imaging) and MR Angiogram. Provides detailed images of brain tissue and blood vessels.
Lumbar puncture. To detect blood in the cerebrospinal fluid if imaging tests are inconclusive.
Cerebral angiography (catheter). Imaging test using injection of contrast dye to visualise the anatomy of the brain’s arteries and veins.

Treatment for a subarachnoid haemorrhage depends on the cause and severity:

Emergency care. Immediate medical attention to stabilise the patient, especially in terms of blood pressure and respiration.
Medications
- Antihypertensives. To lower blood pressure and reduce the risk of further bleeding.
- Anticonvulsants. To prevent or control seizures.
Surgery
- Aneurysm clipping. Surgical procedure (craniotomy) to place a clip on the neck of the aneurysm to stop bleeding.
- Endovascular treatment. Minimally invasive procedure by an interventional radiology team to insert coils or stents through an artery to fill the aneurysm, prevent rupture, and maintain the patency (openness) of the main arteries.
Supportive care. Includes respiratory support, fluid management, and treatment of impaired consciousness.
Rehabilitation. Physical, occupational, and speech therapy to recover lost functions and improve quality of life.