Subarachnoid Hemorrhage

A subarachnoid hemorrhage can best be defined as bleeding between the brain and the thin tissues that cover it. That area is called the “subarachnoid space.”

A subarachnoid hemorrhage has several possible causes:

• Bleeding due to an arteriovenous malformation (AVM). A brain AVM is an abnormal connection between arteries and veins. An AVM is usually congenital, meaning it was present at birth^[1].
• A bleeding disorder.
• Bleeding from a cerebral aneurysm.
• A head injury. When a head injury is the cause of a subarachnoid hemorrhage, it often occurs in people who have fallen or in younger people who have been involved in motor vehicle accidents.
• Use of blood thinners.
• Idiopathic (unknown) causes.

Whatever the cause, a subarachnoid hemorrhage is a catastrophic injury demanding immediate acute care and clinically and relevant neurorehabilitative post-acute rehabilitation. The goal throughout is to provide specialized care to achieve the best possible outcome and, to the greatest extent possible, independence for the individual.

Risk factors that can lead to subarachnoid hemorrhages include:

• The existence of an aneurysm in another blood vessel.
• Fibromuscular dysplasia (FMD). This is a condition that results in the narrowing and enlargement of the medium-sized arteries of the body. The areas of narrowing and enlargement occur adjacent to each other. The result is that the artery can narrow so much that organs that receive blood from the affected artery, including the brain, are damaged^[2].
• High blood pressure. Medicine is often needed to keep blood pressure in check, especially if some of the other risk factors for this condition exist.
• History of polycystic kidney disease. This a progressive disorder that causes many symptoms throughout various parts of the body. It is characterized by cysts on the kidney(s) and often results in the need for kidney replacement.
• Family history of aneurysms^[3].

A subarachnoid hemorrhage is a form of stroke and many are caused by trauma. As we discussed in the article on strokes, by their nature, subarachnoid hemorrhages would be in the nature of a hemorrhagic stroke. When caused by trauma, the hemorrhage often occurs near the site of a skull fracture. This kind of stroke results from a weakening in the blood vessels in the brain and a consequent burst of the vessels. If blood leaks into the brain and fills the space between the brain and skull, the term that is generally used to describe the condition is “subarachnoid hemorrhage,” as opposed to an ischemic stroke.

The severity of a subarachnoid hemorrhage is determined and monitored according to several scales. The Glascow Coma Scale is ubiquitous and is often used for the initial assessment and later, for ongoing measurement of improvement from traumatic brain injuries. The initial determination of brain injury severity is usually made at the site of the catastrophic injury, and on an ongoing basis throughout the various stages of acute care and early rehabilitation. Assessment via the Glasgow Coma Scale may again be carried out at the post-acute rehabilitation phase, and as part of the development and implementation of the Client Goal Plan for clinically relevant services measurements and testing. Depending upon outcomes, NeuLife’s neurorehabilitative therapies may be revised as the client undergoes further.

The professionals at NeuLife, including its team of neurologists, RNs and therapists are expert in the provision of innovative, clinically relevant services, including the development of a customized Client Goal Plan and delivery of neurobehavioral and neurorehabilitative services. NeuLife’s goal is to provide specialized post-acute rehabilitation to its clients that to achieve the best possible outcome for its clients who have even the most difficult and challenging diagnoses.

NeuLife’s philosophy is that healing, wellness and personal fulfillment are best accomplished in a positive and uplifting therapeutic environment where caring staff encourage, assist and support each client so he or she may achieve specific goals. NeuLife believes personal fulfillment is equally as important as goals to increase function and independence. NeuLife seeks to achieve, for all of its clients, maximized, sustained outcomes that exceed the expectations of all persons served.

NeuLife, in Mount Dora, Florida, is a fully accessible residential post-acute program providing specialized rehabilitation to individuals diagnosed with traumatic brain injury (TBI), spinal cord injury (SCI), traumatic amputations and other catastrophic injuries.

2725 Robie Avenue

Mount Dora, Florida 32757

^[1] Mayo Foundation for Medical Research and Learning

^[2] Ibid

^[3] U.S. National Library of Medicine, NIH National Institutes, Subarachnoid Hemorrhage