A subarachnoid hemorrhage is bleeding in an area surrounding the brain. This type of hemorrhagic stroke is often caused by a brain aneurysm that ruptures. Like all strokes, subarachnoid hemorrhages can be devastating and deadly. Call 911 immediately if you’re experiencing an unusual, severe headache (often described as the worst headache of your life) or any other signs of stroke.
With quick surgical intervention, expert intensive care, and comprehensive follow-up treatment, Duke neurologists, neurosurgeons, and others work to reduce deficits and prevent severe complications like paralysis and coma.
Lifesaving Tests and Treatments
People with a suspected subarachnoid hemorrhage need emergency care. It’s critical to find the source of bleeding and stop it quickly to prevent brain damage. Our stroke experts carefully weigh the benefits and risks of each intervention.
A CT scan of the head helps doctors determine whether there is bleeding in the brain and where. To pinpoint the exact bleeding site, you may also need a:
- CT angiogram -- a CT scan that uses contrast dye to map your blood vessels.
- Cerebral angiogram -- doctors make a small incision in your groin, thread a thin and flexible tube called a catheter into an artery, and then inject dye into blood vessels that lead to the brain.
This minimally invasive procedure also requires making a small incision in the groin and threading a catheter to the site of a brain aneurysm. Using an even smaller catheter, a neurosurgeon or interventional radiologist passes one or more thin platinum coils to the site of the bleeding to seal it off.
A neurosurgeon makes an incision in the skull (this is called a craniotomy) and places one or more small metal clips along the neck of the aneurysm. This cuts off blood flow to the aneurysm, prevents it from growing, and reduces the risk for future bleeding.
To reduce the risk of vasospasms (when blood vessels in the brain spasm and narrow, which can cause additional strokes) and other complications, most patients need to stay in an intensive care unit for about two weeks.
Patients with suspected subarachnoid hemorrhages are routed to Duke University Hospital’s emergency room. We offer follow-up and rehabilitation care in locations throughout the Triangle. Find one near you.
Recovery and Rehabilitation
Once you are in a stable condition, we turn our attention to improving your quality of life. Our experts work with you to treat the physical and mental effects of subarachnoid hemorrhages.
As a Duke patient, you have access to a wide range of specialists who can identify deficits and help you improve them. You may be eligible for specialized inpatient rehab programs, such as those offered at the Duke Rehabilitation Institute. We also offer outpatient therapies to restore function and reduce your risk of future strokes, including:
- Physical and occupational therapy
- Risk factor management
- Smoking cessation programs
- Speech therapy for communication disorders like aphasia
- Therapy for oropharyngeal dysphagia
Mental Health and Psychological Care
The mental effects of subarachnoid hemorrhages and other types of strokes are often overlooked. These include mood changes, depression, anxiety, trouble focusing, brain fog, mental fatigue, and more. Duke prioritizes a holistic approach to subarachnoid hemorrhage care, including your mental well-being. Our vascular neurologists and psychologists help you adjust to these changes and address them.
Why Choose Duke
Duke has been recognized for our award-winning stroke care. We’re one of a few hospitals in the region with the expertise and resources required to care for people with subarachnoid hemorrhages and other rare types of strokes. Learn more about our ongoing commitment to improve stroke patient care and outcomes.
Where you receive your care matters. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our neurology and neurosurgery program is nationally ranked, and the highest ranked program in North Carolina by U.S. News & World Report for 2021–2022.