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Horrifying Thunder Headache: What's the Story Behind Submeningeal Hemorrhage?
Subarachnoid Hemorrhage (SAH) is a life-threatening condition that is often associated with a severe headache, known as a "thunder headache" because it comes on so suddenly and violently that it can cause It feels like being hit hard. The underlying cause of this condition is usually related to the rupture of a brain aneurysm, but head trauma or spontaneous bleeding can also trigger the condition. Research shows that about one in five spontaneous submeningeal hemorrhages are due to the presence of an aneurysm, and other factors, including high blood pressure and drug use, may also increase the risk.
A thunderous headache, which is instantly unbearable and is accompanied by a variety of symptoms such as nausea, decreased consciousness or epileptic seizures, is the most typical manifestation of submeningeal hemorrhage.
Symptoms of submeningeal hemorrhage
The most typical symptom is a sudden thunderous headache, which is sometimes described as "like being punched" or "the worst headache I've ever had." About one-third of patients have no significant symptoms other than headache, while about one in ten patients is ultimately diagnosed with submeningeal hemorrhage. In addition to headaches, other symptoms may include vomiting, confusion, and neck stiffness or pain. These symptoms may develop within hours of the bleeding, especially stiffness in the neck, which often develops within six hours of the onset of the headache.
Causes of submeningeal hemorrhage
Most cases of submeningeal hemorrhage result from head trauma or a spontaneously ruptured cerebral aneurysm. Aneurysms usually occur due to weakening of the walls of cerebral blood vessels, most commonly in the circles of the brain (i.e., the Circle of Willis and its branches). Spontaneous bleeding can occur even in the absence of an aneurysm and includes nonaneurysmal peri-mesencephalic hemorrhage and other vascular abnormalities.
Diagnosis and examination methods
Computed tomography (CT scan) without contrast is the test of choice for patients with suspected submeningeal hemorrhage. Studies have shown that if a CT scan is performed within six hours of the onset of symptoms, the detection rate of SAH is as high as 98.7%. If CT results are normal and symptoms persist, a lumbar puncture to examine the cerebrospinal fluid should be considered.
CT scanning is currently the best tool for evaluating submeningeal hemorrhage, but if the time delay is too long, magnetic resonance imaging (MRI) can provide higher sensitivity.
Treatment and Management
The treatment of submeningeal hemorrhage focuses on controlling vital signs as quickly as possible and preventing further bleeding. People usually need to be admitted to an intensive care unit, where their blood pressure, heart rate, and neurological function are constantly monitored. Treatment options include neurosurgery or endovascular curvature therapy to repair the ruptured aneurysm, and medications to control blood pressure if necessary. If the patient demonstrates decreased intellectual ability or if the hemorrhage is extensive, an external ventricular drain may be required to reduce intracranial pressure.
Prognosis and precautions
The prognosis of submeningeal hemorrhage is generally poor, with an estimated half of patients dying within 30 days of the hemorrhage. Even among those who survive, about a third will have long-term health problems. Spontaneous submeningeal hemorrhage occurs in approximately 1 in 100,000 people each year and occurs more frequently in women than in men. Most patients first discover submeningeal hemorrhage before the age of 55, so it is particularly important to understand and recognize the symptoms of this disease.
If a huge headache happened to someone, how would they react? Everyone may face such challenges, but do you know the possibility of submeningeal hemorrhage?
