Subarachnoid Hemorrhage and Hemorrhagic Stroke

by | Sep 2, 2023

Not all strokes happen because of a blood clot. A subarachnoid hemorrhage (SAH) can put someone at risk of a stroke. An SAH may occur at any time and requires immediate medical care. It is necessary to learn what an SAH is and how to reduce the risk of one developing.

big healthy family together on the couch

What is Subarachnoid Hemorrhage?

An SAH is when a weak area of a blood vessel in the brain bursts. It is characterized by bleeding in the space between the brain and the thin layer (arachnoid membrane) that covers and protects the brain. This space is filled with cerebrospinal fluid, and when it is disrupted by bleeding, it can lead to the most common sign, a sudden and severe headache. Patients often describe it as the worst headache of their lives. SAH is typically caused by head trauma and/or the rupture of an aneurysm or a blood vessel in the brain.

When bleeding occurs in the space that surrounds the brain, blood builds up but has nowhere to go, so the brain experiences pressure and can lead to a subarachnoid hemorrhage. 

Difference Between Subarachnoid Hemorrhage and Hemorrhagic stroke

A hemorrhagic stroke also occurs when a weak blood vessel ruptures inside the brain and bleeds. A subarachnoid hemorrhage is a type of hemorrhagic stroke. The difference is that this kind of stroke is when the surface of the brain bleeds. A subarachnoid hemorrhage threatening condition and medical emergency can cause permanent damage and requires immediate treatment.  

Read our “Stroke Causes, Symptoms, Diagnosis, and Treatment: A Complete Guide” blog post to stay informed about the types of stroke, symptoms, screening, diagnosis, treatment options, stroke management, and more.  

Symptoms and Causes of SAH

People can suspect they have an SAH by watching out for warning signs. Several of the symptoms you may experience are:

  • Thunderclap or acute headache
  • A stiff neck
  • Vision changes such as double vision
  • Vomiting
  • Difficulty speaking
  • Sudden weakness
  • Loss of consciousness
  • Drooping eyelid
  • Numbness
  • Muscle aches (particularly in neck and shoulders)
  • Seizures

In many cases, blunt force trauma to the head causes an SAH. The impact can be enough to cause a leak. Some people, however, suffer from an SAH due to a brain aneurysm. A thunderclap headache, which is a very intense, sudden, and painful headache, is the main symptom of a subarachnoid hemorrhage. 

Call 9-9-5 or get to the nearest emergency room immediately if you or a loved one is experiencing a thunderclap headache, especially if you experience these additional SAH symptoms. 

An aneurysm is when a blood vessel swells. If it ruptures, it can lead to an SAH. Pain around the eye, vision problems, and dilated pupils are a few signs of an aneurysm. The Ultimate Guide to Brain Aneurysm post can help you learn about the causes, symptoms, and treatments for this potentially life-threatening condition. When an aneurysm ruptures or bursts, it can lead to hemorrhagic stroke. Learn how brain aneurysms can affect stroke risk in our other article. 

The Risk Factors: Who is Affected by SAH? 

Over 30,000 people suffer from an SAH annually in America. Individuals are most at risk of aneurysm-caused SAH if they have a family history of aneurysms. Excessive drinking of alcohol and smoking also increase the chance of an SAH.

Hypertension, or high blood pressure, is another risk factor. The condition puts stress on blood vessels and weakens their walls. As a result, a rupture is a likely outcome. Age is another factor.

People older than 60 years of age have a higher chance of an SAH. One reason is that blood vessels can weaken over time. Older adults also are more vulnerable to hits to the head after a fall.

Classically, subarachnoid stroke happens more commonly in the young age group of patients and is a known cause of sudden death in younger individuals. 

Diagnosis of SAH

One way to diagnose an SAH is with a CT scan. The doctor uses detailed images of the brain to find the bleeding. The scan, however, may not discover the hemorrhage if it is small or if the rupture occurred over a week ago.

An MRI can find any bleeding that occurred recently. Your doctor might order one if the CT scan came back negative. Another alternative is cerebral angiography. The doctor uses a long tube to inject dye into the blood vessels to produce detailed images.


Stroke Causes, Symptoms, Diagnosis, and Treatment

A stroke occurs when a bleeding or blood clot disrupts the blood supply to the brain. That’s why early detection and intervention can significantly reduce its life-long consequences. Learn more about stroke causes, meaning, symptoms, diagnosis, treatment options, and management.

Treatments of SAH

An SAH is a life-threatening condition and requires hospital care. During surgery, the surgeon locates the cause of the bleeding and repairs it. They place a metal clip on the blood vessel to stop blood from leaking into the brain, which is the main goal.

Another form of treatment for some types of aneurysms is endovascular embolization. The surgeon inserts a coil into the ruptured vein. The coil reduces blood flow and allows the blood to clot. A tiny incision is made in your groin passing a thin tube called a catheter through the artery in your leg that connects up to the artery in your head, which is bleeding. Your doctor can determine if you are a candidate for endovascular embolization after doing an angiogram.

Patients may also use medication to alleviate symptoms and prevent further complications. SAH can be part of a long-term treatment including assessing any risk factors that might have been a trigger for the hemorrhage.

Long-Term Prognosis of SAH

Many people survive an SAH, and recovery is different for everyone. A person might face effects that go away quickly or develop a long-term disability. Examples of effects include speech difficulties, vision issues, risk of seizures, and headaches. Some people have a higher risk of a stroke because of an SAH.

Ways to Reduce SAH

Protective headgear can prevent hemorrhaging when playing sports or working hazardous jobs. Managing blood pressure can limit the risk of an aneurysm-based SAH. Moderate exercise is another way to prevent a hemorrhage. Other lifestyle changes to consider are avoiding smoking and having a healthy diet. Many doctors will recommend quitting smoking as it is a significant risk factor and controlling other conditions including diabetes, high blood pressure, or high cholesterol as they may contribute to SAH.

Access Expert SAH Diagnosis and Stroke Treatment in Singapore

If you are worried about an SAH, the team at Supreme Vascular and Interventional Clinic can help. We have the latest imaging technology to diagnose your hemorrhage. We offer personalized and precise treatment plans to help you recover and return to daily life. We invite you to arrnage your appointment on our contact page to get started.

Stroke Prevention: Causes and Risk Factors

Anyone is capable of having a stroke, but the chances increase if you have certain stroke risk factors, some which are preventable and some which are not.

Consult a Stroke Specialist in Singapore

Dr. Manish Taneja, is an expert in endovascular and image guided neurointerventional procedures of brain and spine. It’s important to find a stroke specialist and doctor you can trust in Singapore. He has special interest in treatment of brain aneurysms, stroke and vascular malformations. Come in for a further evaluation. Arrange an appointment with Dr. Manish Taneja, our neurointervention specialist.


Dr. Manish Taneja performing surgery

Stroke Resources

Benefits and Differences Between Stroke MRI and CT Scans

To determine if you have suffered from a stroke or have the potential to undergo another one, MRI and CT scans are two types of tests that you can get to see what the status may be.

Nurse operating MRI scan for stroke with a patient lying down

We’ve Got You Covered for Specialized Stroke Screening, Prevention, and Management

Imagine heart attacks where the blood flow to your heart is blocked. Similarly, a stroke occurs when the blood flow to your brain is interrupted becoming a “brain attack”. When blood supply does not reach a certain part, brain cells begin to die. Different types of stroke include ischemic strokes (blockage of blood vessel due to blood clot) or a mini stroke, a TIA (transient ischemic attack), with no permanent damage yet serious. Stroke also occurs when a blood vessel in the brain pops causing bleeding in the brain.

Certain areas of the brain can be affected by stroke and some symptoms of a stroke including cardiovascular disease, diabetes, and high blood sugar levels increase the risk of stroke whereas an active lifestyle or controlling high cholesterol reduces the risk. How well do you know stroke? Find tips to prevent and manage stroke, the differences in stroke screening tests, and the newer technology and treatments available. 

Supreme Vascular and Interventional Stroke Programs

Brain Aneurysm Resources

Discover brain aneurysm resources that go beyond the basics designed for patients. Understand the meaning of  a brain aneurysm condition, the causes, symptoms, signs, and more. Connect with your brain health.

Put Brain Aneurysm on Your Health Radar

Did you experience the worst headache of your life? Could it be a brain aneurysm that ruptures, which means bleeding in the brain? Thoughts could be racing through your mind. Then what is the difference between unruptured (a weak or thin spot on an artery in the brain that balloons) or ruptured brain aneurysm? If you’re wondering, then the Supreme Vascular and Interventional Clinic is here to help. It’s important to look out for the tell-tale brain aneurysm symptoms, signs, causes, and risk factors.

Dr. Manish Taneja has been performing brain aneurysm treatments since 1995 from surgical clipping to latest minimally invasive procedures. Each patient is unique as is the size and location of the aneurysm. Your brain has different conditions to treat the aneurysm and artery vessel walls of a blood vessel in the brain. This calls for personalised brain aneurysm treatment depending on your symptoms, family, history, medication, and more. A simple CT scan could be just what the doctor ordered and the first step in early detection and prevention of a brain aneurysm. Come in for an easy consultation with our brain aneurysm specialist in Singapore to be on your health radar.

Other Health Conditions

The Supreme Vascular and Interventional Clinic is your “go-to” facility for various neurological conditions and treatments. To arrange an appointment with Dr. Manish Taneja, our neurointervention specialist, contact us. You can also call us at (+65) 6904 8084 for a consultation.