Subarachnoid Haemorrhage

If there is a leak of blood in the brain, the most prominent symptom is a sudden, severe, maximal at onset headache called Thunderclap Headache.

This sudden leak of blood may cause the person to faint, vomit or go into a coma. In some people it causes sudden death, such as that of the famous Scottish Football (Soccer) Player Davie Cooper in the 1990s.

Most people survive the initial bleeding, but if there is an underlying berry aneurysm (a weakness in the wall of a main brain artery), there is a risk of a second bleeding episode in the next few days.

If a second bleed occurs, this is usually fatal or severely disabling.



This is one of the main reasons that severe headaches are taken seriously.

Nobody wants to have a loss of life or permanent disability that may have been preventable by correct, prompt action.

Damages are frequently paid out by health care providers for loss of life or disability caused by a missed diagnosis of subarachnoid haemorrhage.

Usually the headache is misdiagnosed as migraine, but this trap can be avoided in most cases if care is taken to understand the exact timing of onset of headache.



Cases where there is diagnostic doubt should have a CT brain performed followed by a lumbar puncture if suspicion of SAH remains.

About 4% of people with this type of brain haemorrhage will have had the onset of symptoms during sexual intercourse, and other forms of exertion.

People who present with a first episode of orgasm headache or exercise headache will need to be tested for this type of bleeding in the brain.



More on Acute Headache Diagnosis (how to manage suspected subarachnoid haemorrhage)

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