Subarachnoid Hemorrhage When a Brain Aneurysm Bleeds
Below is a MRR and PLR article in category Health Fitness -> subcategory Other.
Subarachnoid Hemorrhage: Understanding the Threat of a Bleeding Brain Aneurysm
Summary
While most severe headaches are harmless, a headache caused by a bleeding aneurysm is a medical emergency.---
Subarachnoid hemorrhage, often resulting from a ruptured brain aneurysm, is a serious and feared medical condition. It involves bleeding in the space between the brain and its protective membrane, the meninges. This condition can occur spontaneously when aneurysms?"abnormal balloon-like formations on arteries?"burst near the brain's base. Another cause of subarachnoid hemorrhage is trauma, but that is beyond the scope of this discussion.
The Dangers and Complications
Subarachnoid hemorrhages are extremely dangerous. About 10% of individuals with this condition die before reaching a hospital, and more than one-third die within the first month. Survivors often face significant brain damage.
Further complications can arise within weeks after the initial bleed. These include:
1. Re-bleeding: The aneurysm might bleed again, causing more damage. This occurs in 4% of cases within the first 24 hours, with a 1.2% chance of recurring daily for the first two weeks. Without treatment, 20% of cases experience a second hemorrhage in that period.
2. Arterial Spasm: Blood in the subarachnoid space can cause healthy arteries to spasm, reducing blood flow and causing additional strokes. These spasms typically occur 4-9 days after the initial bleed.
Prevention and Treatment
To manage these complications:
- Preventing Spasms: Administering nimodipine intravenously can reduce the likelihood of arterial spasms.
- Preventing Re-bleeding: Surgically stabilizing the aneurysm is essential. Options include:
- Clipping the aneurysm.
- Wrapping it with gauze or sheeting.
- Filling it with metal coils via a catheter.
Recognizing a Bleeding Aneurysm
Identifying a ruptured aneurysm can be challenging, but certain symptoms stand out:
- Sudden, severe headaches described as "thunderclaps."
- Stiff neck, altered vision (seen through an ophthalmoscope), confusion, or reduced limb movement.
A CT scan is effective for detecting hemorrhages within 24 hours, while a lumbar puncture can detect older hemorrhages.
Locating the Source
After diagnosing a subarachnoid hemorrhage, pinpointing the bleeding site is crucial. Though 70% of cases are due to aneurysms, other causes like arteriovenous malformations exist. Diagnostic tests include:
- Arteriogram/Angiogram: An invasive but gold-standard test using dye to visualize arteries.
- Magnetic Resonance Arteriography (MRA) and CT Angiography (CTA): Non-invasive alternatives that sometimes require vein infusion.
These tests can also identify additional unruptured aneurysms, present in about 20% of patients with a ruptured aneurysm.
Prevalence and Risk Factors
Subarachnoid hemorrhages occur in approximately 10 out of every 100,000 people annually (0.01%). This contrasts with migraines, affecting 12% of adults. Most severe headaches aren’t due to aneurysms, but the risk warrants thorough testing.
Factors contributing to aneurysm formation include:
- Inborn arterial wall weaknesses, with risk heightened by hypertension and smoking.
Aneurysms are relatively common, found in 1-4% of the general population, though most never rupture. Those smaller than 5mm have a low rupture risk, while those over 10mm pose a significant threat.
Genetic Considerations
A slight familial tendency for aneurysms exists. A Scottish study reported a 1.2% 10-year risk of subarachnoid hemorrhage among first-degree relatives. The risk increases with multiple affected family members, but routine family screenings aren’t recommended unless multiple relatives are involved.
---
Adapted from original work © 2005 by Gary Cordingley.
You can find the original non-AI version of this article here: Subarachnoid Hemorrhage When a Brain Aneurysm Bleeds.
You can browse and read all the articles for free. If you want to use them and get PLR and MRR rights, you need to buy the pack. Learn more about this pack of over 100 000 MRR and PLR articles.