Thursday, September 3, 2009

Stroke - Subarachnoid Hemorrhage

I had a Subarachnoid Hemorrhage.
A Subarachnoid hemorrhage is bleeding in the area between the brain and the thin tissues that cover the brain. This area is called the subarachnoid space. A Subarachnoid hemorrhage occurs in approximately 10-15 out of 10,000 people. It is more common in women between the ages of 20 and 60. (Definition from Google Health).
My only symptom was a sudden, very severe headache. My husband and I were having a late night conversation when I suddenly felt as if I had been kicked in the side of my head. There were no warning signs.

I went from feeling fine to having a terrible headache, severe muscle aches in my neck and shoulder, nausea, vomiting and sensitivity to light. When it became obvious that I was getting worse, my husband raced me to the nearest hospital which was, luckily, a stroke center. A subarachnoid hemorrhage is considered a stroke, but is often misdiagnosed as a migraine. Once I described the sudden kicked feeling, the triage nurse called for a neurosurgeon to evaluate my condition.

Within minutes, I was given medicine to stop the vomiting, a pain killer, and medicine to prevent blood vessel spasms. The danger of a subarachnoid hemorrhage is the damage that the spilled blood can cause in the brain. Even a little blood can create terrible complications and even cause death. It is terribly important that the bleeding be stopped. Sometimes a shunt is used to draw off the blood. My neurosurgeon’s first concern was to find and stop the bleeding. I was given a head CT scan, spinal tap and a cerebral angiography to determine what needed to be done to stop any bleeding. I was extremely lucky. My bleeding stopped on its own so I did not need surgery.I spent 2 days in the ICU, 4 more days in the hospital, and had another CT scan and cerebral angiography along with several transcranial doppler ultrasounds to make sure the bleeding had stopped. I was on a pain killer because I still had a killer of a headache and a calcium channel blocker to prevent blood vessel spasms the entire 6 days.

Because of the initial bleed, there was blood in the subarachnoid layer that my body had to absorb. Blood is an irritant when outside of the blood vessels. As far as I can tell, blood does not get absorbed quickly. I was in a lot of pain even though I was on pain medicine. Even sitting was uncomfortable. The best I could do was lay on an angle.The neurosurgeons (at this point, three had looked in on me) were wonderful and took the time to explain what had happened to me. I never thought to ask about recovery - like how long I would have a head ache. I could not sit up for several weeks - the pain and pressure were too great - and I needed to rest a lot.

A year after the event, I was still dealing with headaches that would worsen for a few days, then lessen. I had no energy and standing for any length of time was very uncomfortable. I needed to lean my head on something to be comfortable. I leaned on walIs, slouched in chairs to lean my head back, and used pillows to support my neck and head whenever possible. I also had another CT scan to be sure there was not any more bleeding. I resumed a few hours of work in 6 weeks, and full-time after 6 months. I still needed to rest and was not able to get too excited without getting a headache and feeling exhausted.

On a particularly bad day, I was able to get in to see my doctor (not any of the neurosurgeons) who noticed that I was still cringing at light. He told me that sometimes after an injury or bleed, a person could develop migraines. I was prescribed Nortriptyline, an anti-depressant that is used in low dosage for migraine treatment. Within a few weeks, the headaches were gone and my energy had returned as well.
It has been 3 years. About a year ago, I tried to go off of the Nortriptyline, but my headaches returned so I resumed my dosage. When I get tired, I still am less comfortable standing, and I still get headaches and neck-shoulder aches that break through the medication, but I feel extremely lucky to have gotten through a subarachnoid hemorrhage with just a minor headache.

...submitted by a reader from Buffalo, NY. you too can submit your story to Health Gone Ow!

3 comments:

  1. I am a final year medical student in Manchester UK. Thank you so much for telling your story. It has given me a better understanding of SAH. All the best to you.

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  2. i am a nurse student,and i would say thank you for your detailed explanation.your story helped me a lot.

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    1. HI I AM A NURSE ASSISTANT IN AN ACUTE HOSPITAL ON THE MED/SURG, WE SPECIALIZE IN STROKES. THANKS TO YOUR STORY I CAN EXPLAIN BETTER TO MY PATIENTS WHO DONT UNDERSTAND THEIR DOCTORS OR ARE AFRAID TO ASK AND ASK ME. THANKS

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