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SUBARACHNOID HEMORRHAGE

DESCRIPTION

A subarachnoid hemorrhage is sudden bleeding into the subarachnoid space (the area between 2 of the membranes that cover the brain). The space is normally filled with cerebrospinal fluid. The brain, meninges (membranes that cover the brain), blood vessels to the brain, and cranial nerves are involved.
Appropriate health care includes:
  • Physician's monitoring of general condition and medications. This is an emergency!
  • Surgery to stop bleeding and remove collected blood.
  • Long-term rehabilitation.
  • Self-care after treatment.

    SIGNS & SYMPTOMS

  • Acute, severe headache, often followed by unconsciousness.
  • Drowsiness, dizziness, convulsions, or coma.
  • Eye pain with extreme sensitivity to light.
  • Vomiting.
  • Rapid heartbeat and breathing.
  • Stiff neck with pain on movement.
  • Fever.
  • Numbness, weakness, or inability to move an arm or leg.

    CAUSES

  • Head injury (the most common cause).
  • Hardening of the arteries.
  • Infection in any part of the central nervous system.
  • Rupture of an aneurysm (weakened part of an artery) that has been present since birth. Rupture is often preceded by high blood pressure or hardening of the arteries.
  • Bleeding disorder, such as sickle-cell anemia, leukemia, or any that is a side effect of prescription drugs.

    RISK FACTORS

  • High blood pressure.
  • Family history of bleeding disorders.
  • Family history of subarachnoid hemorrhage. Cerebral aneurysms run in families.

    PREVENTING COMPLICATIONS OR RECURRENCE

  • Avoiding head injury is important. Your child should use seat belts in cars and protective head gear in contact sports.
  • Have your child's blood pressure checked regularly. If it is high, consult your doctor for treatment to reduce it.

    BASIC INFORMATION

    MEDICAL TESTS

  • Your own observation of symptoms.
  • Medical history and physical exam by a doctor.
  • Laboratory studies of blood and cerebrospinal fluid.
  • X-rays of the skull.
  • Special studies that may include ultrasonography, CAT or CT scan, MRI, and radionuclide scan (See Glossary for all).

    POSSIBLE COMPLICATIONS

    Death or permanent disability if treatment does not begin soon enough.

    PROBABLE OUTCOME

  • If surgery is possible, recovery chances for your child are good. Partial paralysis, weakness or numbness, and speech and visual difficulties may remain in some cases.
  • The damaged area of the brain cannot be restored. However, undamaged areas of the child's brain often can be taught the lost functions. This usually requires rehabilitation, including physical therapy or speech therapy. Determination and a positive attitude greatly affect the success of the rehabilitation process for your child.

    TREATMENT

    HOME CARE

    At home, consider installing hand bars at the tub and toilet, and ramps at each entry to the house.

    MEDICATION
    Your doctor may prescribe cortisone drugs to reduce the child's brain swelling and pressure.

    ACTIVITY

  • If your child has lost some motor functions, occupational and physical therapists will help the child use the affected limbs to regain basic skills, such as eating, dressing, and toilet functions.
  • After recovery, your child can resume as many former activities as strength and sense of well-being allow. Allow 6 to 12 months for recovery.

    DIET & FLUIDS
    No special diet. Vitamin and mineral supplements should not be necessary unless your child cannot eat normally.

    OK TO GO TO SCHOOL?

    When appetite has returned and alertness, strength, and feeling of well-being will allow.

    CALL YOUR DOCTOR IF

  • Your child has any symptoms of a subarachnoid hemorrhage. This is an emergency!
  • Symptoms recur after surgery. ‡
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