| Spontaneous subarachnoid (pronounced | | | | otherwise healthy arteries passing through this space |
| sub-uh-RACK-noid) hemorrhage is rightfully the most | | | | to go into spasm. The spasm decreases blood-flow to |
| feared cause of sudden headache. Usually due to | | | | the parts of the brain ordinarily nourished by these |
| rupture of aneurysms (abnormal, balloon-like | | | | arteries and thereby inflicts additional damage. Or, said |
| outpouchings of arteries) located near the base of the | | | | another way, a blocked artery causes a new stroke, |
| brain, subarachnoid hemorrhages involve bleeding into | | | | this time of the non-bleeding type. For reasons that are |
| the space between the brain and its surrounding | | | | not entirely understood, these spasms of the arteries |
| membrane, known as the meninges. A traumatic blow | | | | do not occur within the first few days after the initial |
| to the head can also cause subarachnoid hemorrhage, | | | | hemorrhage. Instead, they typically develop after a |
| but this is a completely unrelated process and is not | | | | delay of 4-9 days.What can be done to reduce these |
| the subject of this essay.About 10% of people with | | | | complications? In the case of blood-vessel spasm, the |
| spontaneous subarachnoid hemorrhages die before | | | | best treatment is a preventive one. Administering a |
| they even get to a hospital and over a third die within | | | | drug called nimodipine (prononounced |
| the first four weeks following the bleed. Survivors can | | | | nye-MO-dih-peen) intravenously makes spasming less |
| have significant impairments due to brain damage.And | | | | likely to occur. But in order to prevent the other major |
| while the effects of the initial bleed are bad enough, in | | | | complication, re-bleeding, the best treatments are those |
| the following few weeks individuals with subarachnoid | | | | which physically stabilize the aneurysm. In one such |
| hemorrhage can suffer additional, serious complications. | | | | procedure, a surgeon places a metal clip across the |
| One complication is that the aneurysm responsible for | | | | aneurysm where it joins the otherwise normal artery. |
| the initial hemorrhage can bleed a second time and | | | | An alternative surgery is to wrap the outside of the |
| cause even more damage. This occurs in 4% of | | | | aneurysm with surgical gauze or plastic sheeting. A |
| cases within the first 24 hours and there is another | | | | newer procedure involves filling the aneurysm with tiny |
| 1.2% chance of re-bleeding each day thereafter for | | | | metal coils inserted via a flexible catheter snaked |
| the first two weeks. Thus, without treatment 20% of | | | | through the arteries.How can one tell if a particular |
| cases have a second hemorrhage within the first two | | | | headache is caused by a bleeding aneurysm? It can |
| weeks.The other serious complication is that the blood | | | | be a tough call, but certain features make a ruptured |
| deposited in the subarachnoid space can cause | | | | aneurysm more likely. |