How do you tell the difference between a regular headache and a potential killer headache? Headaches caused by a subarachnoid hemorrhage cause sudden and severe headache pain.
You can suffer paralysis, or even death, if there is a delay in the diagnosis and treatment of a subarachnoid hemorrhage.
What is the key to recognizing a headache caused by a subarachnoid hemorrhage?
A subarachnoid hemorrhage is usually a slight bleed from a cerebral artery. When there is bleeding from a cerebral artery, the patient often suffers from a blindng headache which is often described as the "worst headache of my life". When a person says that he just had the "worst headache of my life", this is a tell-tale sign of a subarachnoid hemorrhage. Another common description of a headache caused by a subarachnoid hemorrhage is a history that the person feels like he "just got hit in the head with a baseball bat".
Headaches caused by a subarachnoid hemorrhage occur suddenly and cause severe, debilitating pain. Often, such persons fall down and must be taken by ambulance to the hospital. The headache pain caused by a subarachnoid hemorrhage causes headache pain that is far more severe and sudden than an ordinary headache.
The key for the medical provider is to get a detailed history from the patient about the headache. The medical provider must ask about the onset of the headache pain, i.e., sudden or gradual onset, the severity of the pain on a scale of 1 to 10, and whether the patient has ever had headache pain like this before. If the headache pain is sudden in onset and severe, a subarachnoid hemorrahge should be presumed to be the cause of the headache until proven otherwise.
How do you rule out a subarachnoid hemorrhage as the cause of the headache?
A CT scan of the brain is the best way to determine whether a subarachnoid hemorrhage is the cause of the headache pain. A CT scan of the brain is very good at detecting a subrachnoid hemorrhage and the imaging study is quick and available at virtually all hospitals. There is no downside to a CT scan of the brain when a subarachnoid hemorrhage is suspected.
The preliminary result of a CT scan of the brain, known as a "wet read", is typically available within 20 minutes from the time the imaging films are taken. If the "wet read" of the CT scan of the brain reveals a subarachnoid hemorrhage, the physician can act quickly to determine the source of the bleeding and have a neurosurgeon evaluate the patient for surgery.
What is the most common cause of a subarachoid hemorrhage?
The most common cause of a subarachnoid hemorhage is an aneurysm. An aneurysm is a small out-poaching of the cerebral artery, which is a part of the artery that has a bubble. The bubble of the artery can leak small amounts of blood and the leak can cause severe and sudden headaches.
The cerebral aneurysm can be fixed by an operation called "clipping", where the aneurysm is clipped with a metal wire. The clipping of the aneurysm causes the collapse of the aneurysm and thus, eliminates further bleeding within the brain.
Why time is of the essence in treating subarachnoid hemorrhage
If a cerebral aneurysm is treated before the onset of neurological symptoms, the patient's likelihood of a full recovery is very high, 95% or higher. However, when a cerebral aneurysm is treated after the onset of neurological symptoms, the likelihood of a complete return to physical and mental well-being is significantly less than 50%. Hence, it is crucial to diagnose and treat a subrachnoid hemorrhage before the patient begins suffering neurological deficits, i.e., lack of feeling or sensation on one side of the body.
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