Subarachnoid hemorrhage

subarachnoid haemorrhagesubarachnoidsubarachnoid hemorrhage, traumaticsubarachnoid bleedingAneurysmal subarachnoid haemorrhagebleeding on her brainbrain bleedbrain hemorrhagehemorrhagichemorrhagic stroke
Subarachnoid hemorrhage (SAH) is bleeding into the subarachnoid space—the area between the arachnoid membrane and the pia mater surrounding the brain.wikipedia
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Thunderclap headache

severe and acute headachesevere headachesevere headache of rapid onset
Symptoms may include a severe headache of rapid onset, vomiting, decreased level of consciousness, fever, and sometimes seizures.
The most important of the secondary causes are subarachnoid hemorrhage, cerebral venous sinus thrombosis, and dissection of an artery in the neck.

Lumbar puncture

spinal tapspinal tapsspinal puncture
Occasionally a lumbar puncture is also required.
Examples of these conditions include meningitis and subarachnoid hemorrhage.

Stroke

ischemic strokestrokescerebrovascular accident
It is a form of stroke and comprises about 5 percent of all strokes.
A hemorrhagic stroke may also be associated with a severe headache.

Head injury

head traumahead injurieshead
SAH may occur as a result of a head injury or spontaneously, usually from a ruptured cerebral aneurysm.
Types of intracranial hemorrhage include subdural, subarachnoid, extradural, and intraparenchymal hematoma.

Nimodipine

Nimotop
Nimodipine, a calcium channel blocker, is frequently used to prevent vasospasm.
It is not frequently used for this indication, but has shown good results in preventing a major complication of subarachnoid hemorrhage (a form of cerebral hemorrhage) termed vasospasm; this is now the main use of nimodipine.

Intracranial aneurysm

brain aneurysmcerebral aneurysmaneurysm
SAH may occur as a result of a head injury or spontaneously, usually from a ruptured cerebral aneurysm.
Lumbar puncture (LP) is the gold standard technique for determining aneurysm rupture (subarachnoid hemorrhage).

Bleeding

hemorrhagehaemorrhagehemorrhaging
Subarachnoid hemorrhage (SAH) is bleeding into the subarachnoid space—the area between the arachnoid membrane and the pia mater surrounding the brain.

Coma

comatoseunresponsivecomatose state
Confusion, decreased level of consciousness or coma may be present, as may neck stiffness and other signs of meningism.
In contrast, coma resulting from a severe traumatic brain injury or subarachnoid hemorrhage can be instantaneous.

Xanthochromia

The CSF sample is also examined for xanthochromia—the yellow appearance of centrifugated fluid.
Xanthochromia, from the Greek xanthos "yellow" and chroma "colour", is the yellowish appearance of cerebrospinal fluid that occurs several hours after bleeding into the subarachnoid space caused by certain medical conditions, most commonly subarachnoid hemorrhage.

Meninges

subarachnoid spacemeningealleptomeninges
Subarachnoid hemorrhage (SAH) is bleeding into the subarachnoid space—the area between the arachnoid membrane and the pia mater surrounding the brain.

Vertebral artery dissection

cervical artery dissectionDissection of the vertebral arteryDissection of vertebral artery
Dissection of the vertebral artery, usually caused by trauma, can lead to subarachnoid hemorrhage if the dissection involves the part of the vessel inside the skull.
If the dissection of the artery extends to the part of the artery that lies inside the skull, subarachnoid hemorrhage may occur (1% of cases).

Terson syndrome

Terson's syndrome
This is known as Terson syndrome (occurring in 3–13 percent of cases) and is more common in more severe SAH.
Terson syndrome or Terson's syndrome is the occurrence of a vitreous hemorrhage of the human eye in association with subarachnoid hemorrhage.

Vasospasm

vascular spasmspasm of the coronary arteriesvasospasm, intracranial
These include the prevention of rebleeding by obliterating the bleeding source, prevention of a phenomenon known as vasospasm, and prevention and treatment of complications.
Cerebral vasospasm may arise in the context of subarachnoid hemorrhage.

Epileptic seizure

seizureseizuresepileptic seizures
Symptoms may include a severe headache of rapid onset, vomiting, decreased level of consciousness, fever, and sometimes seizures.
There is no clear evidence that antiepileptic drugs are effective or not effective at preventing seizures following a craniotomy, following subdural hematoma, after a stroke, or after subarachnoid haemorrhage, for both people who have had a previous seizure, and those who have not.

Polycystic kidney disease

polycystic kidneypolycystic kidneysAutosomal dominant polycystic kidney disease
Autosomal dominant polycystic kidney disease (ADPKD), a hereditary kidney condition, is known to be associated with cerebral aneurysms in 8 percent of cases, but most such aneurysms are small and therefore unlikely to rupture.
This genetic defect can also cause aortic root aneurysms, and aneurysms in the circle of Willis cerebral arteries, which if they rupture, can cause a subarachnoid hemorrhage.

Intraocular hemorrhage

Bleeding into the eyeHaemophthalmos
Intraocular hemorrhage (bleeding into the eyeball) may occur in response to the raised pressure: subhyaloid hemorrhage (bleeding under the hyaloid membrane, which envelops the vitreous body of the eye) and vitreous hemorrhage may be visible on fundoscopy.

Cerebral venous sinus thrombosis

cerebral venous thrombosisdural sinus thrombosissagittal sinus thrombosis
As only 10 percent of people admitted to the emergency department with a thunderclap headache are having an SAH, other possible causes are usually considered simultaneously, such as meningitis, migraine, and cerebral venous sinus thrombosis.
The diagnosis may be suspected on the basis of the symptoms, for example the combination of headache, signs of raised intracranial pressure and focal neurological abnormalities, or when alternative causes of headache and neurological abnormalities, such as a subarachnoid hemorrhage, have been excluded.

Cerebral arteriovenous malformation

arteriovenous malformationsintracranial arteriovenous malformationscerebral AVM
SAH in a person known to have seizures is often diagnostic of a cerebral arteriovenous malformation.
If a rupture or bleeding incident occurs, the blood may penetrate either into the brain tissue (cerebral hemorrhage) or into the subarachnoid space, which is located between the sheaths (meninges) surrounding the brain (subarachnoid hemorrhage).

Migraine

migrainesmigraine headachemigraine headaches
As only 10 percent of people admitted to the emergency department with a thunderclap headache are having an SAH, other possible causes are usually considered simultaneously, such as meningitis, migraine, and cerebral venous sinus thrombosis.
Other conditions that can cause similar symptoms to a migraine headache include temporal arteritis, cluster headaches, acute glaucoma, meningitis and subarachnoid hemorrhage.

Intraventricular hemorrhage

Intraventricular haemorrhagebleeding into the brain's ventriclesintraventricular
This scale has been modified by Claassen and coworkers, reflecting the additive risk from SAH size and accompanying intraventricular hemorrhage (0 – none; 1 – minimal SAH w/o IVH; 2 – minimal SAH with IVH; 3 – thick SAH w/o IVH; 4 – thick SAH with IVH);.
Brain contusions and subarachnoid hemorrhages are commonly associated with IVH.

Oculomotor nerve

oculomotorIIIcranial nerve III
Oculomotor nerve abnormalities (affected eye looking downward and outward and inability to lift the eyelid on the same side) or palsy (loss of movement) may indicate bleeding from the posterior communicating artery.

Ventricular system

ventriclesventricleventricular
As a consequence of the sympathetic surge there is a sudden increase in blood pressure; mediated by increased contractility of the ventricle and increased vasoconstriction leading to increased systemic vascular resistance.
Other diseases of the ventricular system include inflammation of the membranes (meningitis) or of the ventricles (ventriculitis) caused by infection or the introduction of blood following trauma or haemorrhage (cerebral haemorrhage or subarachnoid haemorrhage).

Pituitary apoplexy

problems with the pituitary gland
Cocaine abuse and sickle cell anemia (usually in children) and, rarely, anticoagulant therapy, problems with blood clotting and pituitary apoplexy can also result in SAH.
In some instances, lumbar puncture may be required if there is a suspicion that the symptoms might be caused by other problems (meningitis or subarachnoid hemorrhage).

Endothelin

endothelin-1endothelin-3endothelins
Oxyhaemoglobin in cerebrospinal fluid (CSF) causes vasoconstriction by increasing free radicals, endothelin-1, prostaglandin and reducing the level of nitric oxide and prostacyclin.

Hydrocephalus

hydrocephalyhydrocephalicobstructive hydrocephalus
Hydrocephalus (obstruction of the flow of cerebrospinal fluid) may complicate SAH in both the short and long term.
Other causes include meningitis, brain tumors, traumatic brain injury, intraventricular hemorrhage, and subarachnoid hemorrhage.