The following are the major diseases or complications that may be contributed to by subarachnoid hemorrhage (SAB):
Eyes and eye appendages (H00-H59).
- Terson syndrome – hemorrhage into the vitreous (corpus vitreum) and retina (retina) due to an increase in pressure of the retinal veins; considered a prognostically unfavorable parameter.
Endocrine, nutritional, and metabolic diseases (E00-E90).
- Hyponatremia (sodium deficiency)-in approximately 30% of cases; in the setting of subarachnoid hemorrhage, mechanical irritation of the hypothalamus may occur; as a result, antidiuretic hormone (ADH) secretion increases, leading to dilutional hyponatremia.
Cardiovascular system (I00-I99).
- Arrhythmias (cardiac arrhythmias), neurogenic.
- Cerebral infarction (20-40% of cases).
- Intracerebral hemorrhage (ICB; cerebral hemorrhage).
- Cardiogenic pulmonary edema (heart-related pulmonary edema/water retention in the lungs).
- Myocardial infarction (heart attack)
- Recurrent hemorrhage (bleeding again) – the risk of recurrent hemorrhage is highest in the first three days
- Approximately 35% of rebleeding occurs in the first three hours
- Up to 49% in the first six hours
- Stress cardiomyopathy (synonyms: Broken heart syndrome, Tako-Tsubo cardiomyopathy (Takotsubo cardiomyopathy), Tako-Tsubo cardiomyopathy (TTC), Tako-Tsubo syndrome (Takotsubo syndrome, TTS), transient left ventricular apical ballooning) – primary cardiomyopathy characterized by short-term impairment of myocardial function in the setting of overall unremarkable coronary vessels; clinical symptoms: Symptoms of acute myocardial infarction with acute chest pain, typical ECG changes, and elevation of myocardial markers in the blood; in approx. 1-2% of patients with a suspected diagnosis of acute coronary syndrome are found to have TTC on cardiac catheterization instead of the presumed diagnosis of coronary artery disease (CAD); nearly 90% of patients affected by TTC are postmenopausal women; increased mortality in younger patients, particularly in men, largely due to increased rates of cerebral hemorrhage and epileptic seizures
- Subdural hematoma (SDH) – hematoma (bruise) under the hard meninges between the dura mater (hard meninges) and the arachnoid membrane (cobweb skin)
- Vasospasm (constriction of affected vessels) and secondary ischemia (reduced supply of oxygen to brain tissue) – between days 4 and 14 after aneurysmal SAB; it usually lasts two to three weeks; subsequently, ischemia occurs
Psyche – Nervous System (F00-F99; G00-G99).
- Epileptic seizures (convulsions) (10% of cases).
- Brain edema (swelling of the brain)
- Hydrocephalus (pathological expansion of the fluid spaces (cerebral ventricles) of the brain filled with cerebrospinal fluid) (25% of cases) – two forms are distinguished in this context:
- Hydrocephalus aresorptivus (synonym: malresorptivus) – the hemorrhage impairs the reabsorption of cerebrospinal fluid (cerebrospinal fluid (CSF), colloquially “nerve fluid”)
- Hydrocephalus occlusus (rarer) – here the bleeding breaks into the ventricular system (cavity system in the brain) (intraventricular hemorrhage (IVB)).
- Hydrocephalus develops within hours to weeks after SAB. In some cases, spontaneous regression occurs.
- Drainage of the accumulated cerebrospinal fluid (brain water) is usually necessary: Installation of an external ventricular drainage (EVD).
- If the drainage is necessary over a longer period of time, a ventriculoperitoneal (drainage into the abdominal cavity) or ventriculoartial (drainage into the right atrium) shunt is surgically placed.
