What’s a subarachnoid hematoma?

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A subarachnoid hematoma is the accumulation of blood under the second of the three brain membranes. The innermost protective lining of the brain is called the pia mater, and the outermost lining is known as the dura mater. Between these membranes is the central, or second, membrane known as the arachnoid. When bleeding occurs into the space under the arachnoid, the hemorrhage is formally referred to as a “subarachnoid hematoma.” This hematoma is considered extremely dangerous and potentially life threatening.

Several risks can arise from a subarachnoid hematoma. Strokes are often linked to these bleedings, as are seizures. Besides death, the greatest danger associated with a subarachnoid hematoma is long-term brain damage.

Bleeding under the arachnoid can result from many triggers. A physical accident that causes trauma to the brain, such as a fall or an automobile accident, for example, can lead to a subarachnoid hematoma. This cause is especially prevalent in vulnerable people, such as children or the elderly.

Abnormal formation of blood veins in the brain during fetal development – ​​a condition known as arteriovenous malformation – is another trigger. During this malformation, the arteries that carry blood to the brain connect directly to the veins without the aid of capillaries. This can result in a buildup of pressure within the veins and arteries which can cause them to burst.

Brain aneurysms and the use of medications that thin the blood or prevent clotting can also lead to subarachnoid hematomas. Blood disorders can also cause hematomas and, sometimes, spontaneous subarachnoid hemorrhages can occur without a recognizable cause. These are referred to as idiopathic hematomas.

Certain demographics are more susceptible to subarachnoid hematomas than others. For example, women have more hematomas in the subarachnoid space than men. Also, according to medical studies, people over the age of 20 and under the age of 60 also tend to be more susceptible. Other people at increased risk of having brain hematomas include those with high blood pressure, fibromuscular dysplasia, or a smoking habit.

A subarachnoid hematoma does not always have to lead to death. If symptoms are caught early, doctors may try to treat the condition. Symptoms include loss of mobility, unconsciousness, and nausea. Sometimes, mental confusion, photosensitivity, and sudden vision problems are clues that a hematoma may be present. Doctors say some people with hematomas also experience seizures.

CT scans, ultrasounds, and other neurological tests are used to identify a subarachnoid hematoma. After detection and localization, surgeons can attempt to stop the bleeding and relieve pressure in the brain. Sometimes, doctors may need to make a circular incision in the brain and insert coils to repair aneurysms and prevent future bleeding.

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