Spontaneous subarachnoid hemorrhage: A primer for acute care practitioners.

Abstract

Subarachnoid hemorrhage (SAH) refers to intracranial bleeding into the cerebrospinal filled space beneath the arachnoid membrane that covers the brain. It is further defined as a spontaneous SAH when not associated with trauma. The commonest single cause is rupture of a saccular (i.e. a small bag-shaped or pouch-shaped) intracranial aneurysm, arising from the larger conducting arteries traveling through the subarachnoid space at the base of the brain. As these are high-pressure and higher-volume arterial hemorrhages, aneurysmal subarachnoid hemorrhages (aSAH) are associated with high early mortality and substantial long-term morbidity. But, as we outline below, prompt and collaborative multidisciplinary care can improve the likelihood and quality of survival. Accordingly, we offer the following primer as a common resource to increase knowledge and collaborative care.