Subarachnoid Haemorrhage
Subarachnoid haemorrhage (SAH) is bleeding into the fluid-filled space surrounding the brain, often after an aneurysm ruptures. It requires immediate emergency assessment and brain imaging.
Key takeaways
- A thunderclap headache reaches peak intensity within seconds or minutes and may accompany vomiting, neck stiffness, light sensitivity or collapse.
- Symptoms alone cannot confirm SAH; urgent CT and sometimes additional tests are needed even if the headache improves.
- Treatment addresses the bleeding source and hospital complications; catalogue medicines have no role in self-treatment.
Catalogue matches are not emergency care and must not delay ambulance transfer and specialist imaging.
What happens after the initial bleed?
Rebleeding, hydrocephalus, seizures and delayed cerebral ischaemia can cause further brain injury. Neurological monitoring and treatment of the aneurysm are central, while blood pressure and fluid management are carefully controlled.
What is nimodipine used for?
Nimodipine is used in hospital after aneurysmal SAH to reduce poor outcomes related to delayed cerebral ischaemia. It does not stop the original bleed or replace aneurysm treatment and can lower blood pressure.
When to seek urgent care
Call emergency services for any sudden maximal-intensity headache, especially with collapse, vomiting, neck stiffness, seizure, confusion, weakness, speech change or vision loss.