A subarachnoid haemorrhage (SAH) is a serious medical emergency that can cause life-changing brain damage if not recognised and treated quickly. The impact of a subarachnoid haemorrhage can be devastating, both for the person affected and their loved ones. What is a subarachnoid haemorrhage? A subarachnoid haemorrhage is a type of stroke caused by bleeding into the subarachnoid space — the area between the brain and the thin tissues that cover the brain. This space is normally filled with cerebrospinal fluid, which cushions the brain. When bleeding occurs here, it can increase pressure on the brain and interrupt the normal flow of oxygen-rich blood. SAH most commonly results from the rupture of a brain aneurysm — a weak spot in a blood vessel in the brain that bulges and eventually bursts. More rarely, it can be caused by trauma (such as a head injury), arteriovenous malformations, or certain medical conditions. Subarachnoid haemorrhage symptoms Recognising the signs of a subarachnoid haemorrhage quickly is critical. Classic subarachnoid haemorrhage symptoms include: A sudden, severe headache, often described as the worst headache of your life Neck stiffness Nausea or vomiting Blurred or double vision Sensitivity to light Confusion or altered consciousness Seizures Weakness or numbness, especially on one side of the body These symptoms can be sudden and dramatic. Anyone experiencing these symptoms should seek immediate medical help. How SAH leads to brain damage The brain is extremely sensitive to changes in blood flow and pressure. When a subarachnoid haemorrhage occurs, several damaging processes can begin almost immediately. 1. Increased intracranial pressure The skull is a closed space. When bleeding occurs inside the skull, the volume increases, raising intracranial pressure. This pressure can compress brain tissue, reduce blood flow, and cause cells in the brain to die. 2. Reduced oxygen supply The bleed can interrupt the normal circulation of blood to the brain. Areas starved of oxygen and nutrients (a condition called ischaemia) can become damaged in a matter of minutes. If not promptly treated, this can result in permanent long-term disability or even death. 3. Vasospasm A few days after the initial bleed, a dangerous complication called cerebral vasospasm can occur. This is when the blood vessels in the brain narrow, limiting blood supply and potentially causing secondary strokes. Vasospasm is a major cause of delayed brain injury in patients who survive the initial haemorrhage. 4. Hydrocephalus Blood from the haemorrhage can block the normal flow or absorption of cerebrospinal fluid, leading to hydrocephalus, which is a build-up of fluid in the brain that causes further pressure and damage. 5. Inflammation and toxicity Blood is toxic to brain tissue outside of blood vessels. The breakdown products of blood cells can trigger inflammation, swelling, and the destruction of healthy brain cells. Subarachnoid haemorrhage diagnosis Rapid and accurate subarachnoid haemorrhage diagnosis is essential to improve the chances of survival and reduce the risk of permanent brain injury.Common diagnostic steps include: CT Scan: A non-contrast CT scan is usually the first test performed and can detect most cases of SAH within 24 hours of symptom onset. Lumbar Puncture: If the CT scan is inconclusive but SAH is still suspected, a lumbar puncture (spinal tap) may be done to detect blood in the cerebrospinal fluid. CT Angiography or MR Angiography: These tests help identify the source of the bleed, such as an aneurysm. Digital Subtraction Angiography (DSA): The gold standard for identifying aneurysms, though more invasive. Delays or errors in diagnosis can have catastrophic consequences, which is why emergency departments must follow established protocols when SAH is suspected. Management of subarachnoid haemorrhage The management of subarachnoid haemorrhage typically occurs in a specialist neurosurgical or stroke unit and may involve: Securing the aneurysm to prevent re-bleeding, usually by surgical clipping or endovascular coiling. Managing intracranial pressure and ensuring adequate blood flow to the brain. Preventing complications, such as vasospasm, seizures, and hydrocephalus. Supportive care, including blood pressure control, pain management, and intensive monitoring. Rehabilitation and long-term care are also vital parts of SAH management, particularly for those left with neurological deficits. Consequences of SAH: living with brain damage Sadly, when a SAH isn’t diagnosed promptly (sometimes as a result of medical negligence), a patient can be left with serious long-term disabilities. These can include: Cognitive problems (memory loss, difficulty concentrating) Physical disabilities (weakness, coordination issues) Emotional and behavioural changes (depression, personality change) Speech and language difficulties Fatigue In more severe cases, SAH can result in a persistent vegetative state or death. Recovery is highly variable and depends on the severity of the initial bleed, complications, and the quality of care received. Subarachnoid haemorrhage claim: when medical negligence plays a role If a subarachnoid haemorrhage is not diagnosed or managed in a timely and/or appropriate manner, and this leads to avoidable harm, it may be possible to pursue a subarachnoid haemorrhage claim for medical negligence. Examples of negligent care may include: Failure to recognise or act upon classic subarachnoid haemorrhage symptoms Misdiagnosis (e.g., attributing the headache to migraine) Delayed imaging or specialist referral Inadequate monitoring or treatment following the initial diagnosis Surgical or interventional errors A successful claim can help secure compensation for pain and suffering, loss of earnings, care costs, and future rehabilitation needs. As specialist medical negligence solicitors, we work with individuals and families affected by brain injuries caused by SAH to help them obtain justice and the financial support they need. If you or a loved one has experienced a subarachnoid haemorrhage and you believe errors in care contributed to a worse outcome, it is important to seek legal advice as soon as possible. Our experienced medical negligence solicitors are here to help. Contact us by email at mednegclaims@boyesturner.com.
