Subarachnoid Hemorrhage (SAH):

This type of bleeding in the brain occurs in the membranes that surround the brain and is typically due to trauma or the rupture of an aneurysm. An aneurysm is an abnormal ballooning of an artery that most patients are born with. Smoking, high blood pressure and cocaine use can contribute to the formation and growth of aneurysms. Most aneurysms rupture when patients reach age 40-60. Aneurysms should be repaired as soon as possible either with surgery or endovascular coiling. The next 3-14 days after aneurysm rupture represents the vasospasm period. During this time, other brain vessels can become irritable and spasm or clench up. Spasm limits the amount of blood that can pass through that vessel to supply nourishment to the brain. In the worst case scenario, stroke can occur due to vasospasm. Neurointensivists carefully watch patients for the development of vasospasm so they can intervene with medical or endovascular treatments to prevent stroke. Most subarachnoid hemorrhage patients will spend at least 1 week in the ICU. Outcome after SAH depends primarily on the patient’s age, his or her clinical status at presentation (depth of coma etc) and the size of the aneurysm that ruptured.