Subarachnoid hemorrhage

A sudden, very severe headache — the kind people describe as "the worst headache of my life" — can be a sign of a subarachnoid hemorrhage (SAH). That’s bleeding into the space around the brain. It’s serious and needs fast action. This page explains what SAH looks like, what to do immediately, and what to expect in hospital, in plain language.

What causes it and how it shows up

Most often SAH comes from a ruptured brain aneurysm. Trauma, arteriovenous malformations, or rare bleeding disorders can also cause it. Typical signs to watch for:

- Sudden, extremely severe headache (thunderclap headache) that peaks within seconds to minutes.
- Neck stiffness, nausea, or vomiting.
- Sensitivity to light (photophobia).
- Confusion, drowsiness, or loss of consciousness.
- Focal weakness or numbness in parts of the body.

If you or someone else has these symptoms, treat it as a medical emergency.

What to do right away and in the hospital

At home: call emergency services immediately. Keep the person still and calm. Don’t give them blood thinners (like aspirin, warfarin) unless a doctor tells you to. Try to note when the headache started and any medical history (high blood pressure, smoking, family history of aneurysms).

In the ER: doctors will usually do a CT scan first. If CT is negative but suspicion remains, a lumbar puncture may follow to detect blood in the spinal fluid. Cerebral angiography or CT angiography helps find the bleeding source.

Treatment focuses on stopping the bleeding and preventing complications. Options include endovascular coiling or surgical clipping of an aneurysm. Doctors also control blood pressure, give nimodipine to reduce the risk of delayed brain vessel spasm, and monitor for seizures or hydrocephalus (fluid buildup). Many patients need ICU care for close monitoring during the first 10–14 days, when vasospasm risk is highest.

Recovery varies. Some people recover well with minimal deficits; others need rehab for physical, speech, or cognitive problems. Follow-up imaging and blood pressure control matter. Smoking cessation and managing hypertension lower future risk.

Want more reading from UniversalDrugstore.com? Check our related articles on intracranial pressure and headache care, like "Acetazolamide for Pseudotumor Cerebri" and pieces on migraine management that explain symptom overlap.

If you think someone has a subarachnoid hemorrhage, don’t wait. Quick medical care saves lives and reduces long-term problems.