Subarachnoid Hemorrhage

If your healthcare provider suspects you have a subarachnoid hemorrhage based on your symptoms and a physical exam, they’ll immediately order a CT (computerized tomography) scan.

A CT scan uses X-rays and a computer to make detailed images of tissues in your body. A CT scan of your brain is an effective way for your provider to see a subarachnoid hemorrhage. Another type of CT scan, CT angiography (CTA), visualizes blood vessels using contrast material injected through a vein.

Sometimes, a CT scan may miss a very small subarachnoid hemorrhage or one that occurred a week or two ago. Your provider will likely order other tests to detect a subarachnoid hemorrhage if a CT scan is negative.

These tests include:

• Lumbar puncture: For this test, your provider injects a small needle in the lowest part of your back to obtain cerebrospinal fluid (CSF), the fluid that surrounds your brain and spinal cord. The fluid is tested for xanthochromia (a yellowish appearance), which indicates subarachnoid hemorrhage.
• Brain magnetic resonance imaging (MRI): This imaging test can show if there’s been “subacute” blood, or bleeding in your brain, in the recent past.

The hospital care following the diagnosis of subarachnoid hemorrhage focuses on both discovering and treating the cause of the SAH, as well as managing its complications.

As brain aneurysms cause over 80% of non-traumatic subarachnoid hemorrhages, your provider will likely order a cerebral angiogram to get images of your brain’s arteries and then treat the aneurysm.