Subarachnoid hemorrhage history and symptoms

Subarachnoid Hemorrhage Microchapters

Home

Patient Information

Overview

Classification

Pathophysiology

Causes

Differentiating Subarachnoid Hemorrhage from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

AHA/ASA Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage (2012)

Risk Factors/Prevention
Natural History/Outcome
Clinical Manifestations/Diagnosis
Medical Measures to Prevent Rebleeding
Surgical and Endovascular Methods
Hospital Characteristics/Systems of Care
Anesthetic Management
Cerebral Vasospasm and DCI
Hydrocephalus
Seizures Associated With aSAH
Medical Complications

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Subarachnoid hemorrhage history and symptoms On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Subarachnoid hemorrhage history and symptoms

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Subarachnoid hemorrhage history and symptoms

CDC on Subarachnoid hemorrhage history and symptoms

Subarachnoid hemorrhage history and symptoms in the news

Blogs on Subarachnoid hemorrhage history and symptoms

Directions to Hospitals Treating Subarachnoid hemorrhage

Risk calculators and risk factors for Subarachnoid hemorrhage history and symptoms

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:  Syed Ahsan Hussain, M.D.[2] Cafer Zorkun, M.D., Ph.D. [3]; Sara Mehrsefat, M.D. [4]

## Overview

[edit | edit source]

The classic symptom of subarachnoid hemorrhage is thunderclap headache ("most severe ever" headache developing over seconds to minutes). This headache is often described like being "kicked in the head".[1] 10% of all people with this symptom turn out to have a subarachnoid hemorrhage, and is the only symptom in about a third of all SAH patients. Other presenting features may be vomiting (non-specific), seizures (1 in 14) and meningism. Confusion, decreased level of consciousness or coma may be present. Intraocular hemorrhage (bleeding into the eyeball) may occur. Subhyaloid hemorrhages may be visible on fundoscopy (the hyaloid membrane envelopes the vitreous body).

## History and symptoms

[edit | edit source]

### History

[edit | edit source]

It is critical to obtain a detailed and focused history.[2][3][4][5][6][7][8][9][10]

History | Comments

|

Timing of the symptoms onset |

* The time the patient was last normal

Initial symptoms |

* The progression of symptoms

Vascular risk factors |

* Hypertension
* Smoking

Medications |

* Decongestants
* Antihypertensive medications
* Stimulants (including diet pills)
* Sympathomimetics

Recent trauma |

* History of recent fall or accident

Dementia |

* Associated with amyloid angiopathy

Alcohol or illicit drug use |

* Cocaine
* Other sympathomimetic drugs

Cancer |

* History of brain or cervical tumors

### Symtoms

[edit | edit source]

It is impossible to know whether symptoms are due to ischemia, hemorrhage, or other medical reason based on clinical characteristics alone. The abrupt onset of focal neurologic symptoms is presumed to be vascular in origin.

Non specific symptoms of hemorrhagic stroke may include the following:[8][9][11][10]

* Severe headache (as a worst headache of the life)
* Double vision
* Nausea and vomiting
* Symptoms meningeal irritation
* Nuchal rigidity and pain
* Back pain
* Bilateral leg pain
* Numbness
* Weakness
* Sudden decreased level of consciousness
* Rapid progression of symptoms
* Speech disturbance

## References

[edit | edit source]

1. ↑ Longmore, Murray (2007). Oxford Handbook of Clinicial Medicine. Oxford. p. 841\. ISBN 0-19-856837-1. Unknown parameter `|coauthors=` ignored (help)
2. ↑ Huhtakangas J, Tetri S, Juvela S, Saloheimo P, Bode MK, Hillbom M. Effect of increased warfarin use on warfarin-related cerebral hemor- rhage: a longitudinal population-based study. Stroke. 2011;42:2431– 2435. doi: 10.1161/STROKEAHA.111.615260.
3. ↑ Rådberg JA, Olsson JE, Rådberg CT. Prognostic parameters in sponta- neous intracerebral hematomas with special reference to anticoagulant treatment. Stroke. 1991;22:571–576. doi: 10.1161/01.STR.22.5.571.
4. ↑ Flaherty ML, Kissela B, Woo D, Kleindorfer D, Alwell K, Sekar P, Moomaw CJ, Haverbusch M, Broderick JP. The increasing incidence of anticoagulant-associated intracerebral hemorrhage. Neurology. 2007;68:116–121. doi: 10.1212/01.wnl.0000250340.05202.8b.
5. ↑ Ariesen MJ, Claus SP, Rinkel GJ, Algra A (2003). "Risk factors for intracerebral hemorrhage in the general population: a systematic review". Stroke. 34 (8): 2060–5. doi:10.1161/01.STR.0000080678.09344.8D. PMID 12843354.CS1 maint: Multiple names: authors list (link)
6. ↑ Bos MJ, Koudstaal PJ, Hofman A, Breteler MM (2007). "Decreased glomerular filtration rate is a risk factor for hemorrhagic but not for ischemic stroke: the Rotterdam Study". Stroke. 38 (12): 3127–32. doi:10.1161/STROKEAHA.107.489807. PMID 17962600.CS1 maint: Multiple names: authors list (link)
7. ↑ Hackam DG, Mrkobrada M (2012). "Selective serotonin reuptake inhibitors and brain hemorrhage: a meta-analysis". Neurology. 79 (18): 1862–5. doi:10.1212/WNL.0b013e318271f848. PMID 23077009. Review in: Evid Based Ment Health. 2013 May;16(2):54
8. ↑ 8.0 8.1 Fisher CM (1971). "Pathological observations in hypertensive cerebral hemorrhage". J Neuropathol Exp Neurol. 30 (3): 536–50. PMID 4105427.
9. ↑ 9.0 9.1 Gorelick PB, Hier DB, Caplan LR, Langenberg P (1986). "Headache in acute cerebrovascular disease". Neurology. 36 (11): 1445–50. PMID 3762963.CS1 maint: Multiple names: authors list (link)
10. ↑ 10.0 10.1 Fontanarosa PB (1989). "Recognition of subarachnoid hemorrhage". Ann Emerg Med. 18 (11): 1199–205. PMID 2683901.
11. ↑ Qureshi AI, Tuhrim S, Broderick JP, Batjer HH, Hondo H, Hanley DF (2001). "Spontaneous intracerebral hemorrhage". N Engl J Med. 344 (19): 1450–60. doi:10.1056/NEJM200105103441907. PMID 11346811.CS1 maint: Multiple names: authors list (link)

Template:WH Template:WS