00:03Subarachnoid hemorrhage is bleeding into the subarachnoid space, the thin space between
00:08two layers of the meninges, the arachnoid mater and pia mater.
00:12The subarachnoid space is normally filled with cerebrospinal fluid.
00:17Subarachnoid hemorrhage is a type of stroke and a medical emergency with a high risk of
00:21mortality.
00:23This video focuses on non-traumatic or spontaneous subarachnoid hemorrhage, rather than subarachnoid
00:29hemorrhage caused by trauma, which often involves a different clinical course and treatment.
00:35Spontaneous subarachnoid hemorrhage can be caused by a variety of conditions, but the most common
00:39and severe cases typically result from the rupture of a brain aneurysm.
00:44Subarachnoid hemorrhage usually begins suddenly, with a severe headache that develops within
00:48seconds, sometimes referred to as a thunderclap headache.
00:51Patients often describe the headache as the most severe headache they've ever experienced.
00:55A variety of other symptoms may also occur, including vomiting, neck pain or stiffness,
01:01loss of consciousness, or seizures.
01:05Diagnosis typically involves a CT scan to look for blood in the subarachnoid space.
01:10If the CT scan is negative, but suspicion of subarachnoid hemorrhage remains high, a lumbar
01:15puncture can be done to examine the cerebrospinal fluid for red blood cells or xanthochromia,
01:20a yellowish discoloration of cerebrospinal fluid caused by the breakdown of blood cells.
01:26Once subarachnoid hemorrhage has been confirmed, vascular imaging can be used to locate the
01:30source of the bleeding.
01:32Treatment aims first to address the cause of bleeding.
01:35If an aneurysm is identified, it is typically treated to prevent blood from entering into the
01:39aneurysm.
01:41Then, patients are monitored and treated to prevent complications such as re-bleeding, brain ischemia,
01:46anhydocephalus.
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