the Recurrence Risk of Traumatic Subarachnoid Hemorrhage

The recurrence rate of traumatic subarachnoid hemorrhage?

Hello Doctor, I accidentally hit my head while walking two weeks ago.
At that moment, I felt fine, but four days later, I suddenly experienced severe pain in my head.
I was taken to the emergency room and diagnosed with subarachnoid hemorrhage (the CT scan showed only one white spot).
After a week of hospitalization, I am now able to resume normal activities.
An MRI confirmed that the bleeding point has absorbed and disappeared, but I still occasionally experience headaches and dizziness.
My attending physician told me that this is migraine caused by head trauma.
Is there a chance that this type of migraine can heal? It is affecting my daily life, and I am very troubled by it.

I have another question: I read online that if subarachnoid hemorrhage is caused by a ruptured aneurysm, there is a risk of recurrence.
Since my condition was caused by head trauma and I do not have a brain aneurysm, is there still a possibility of recurrence? Also, can I engage in vigorous exercise? Will prolonged activities that require mental effort worsen my condition? Thank you, Doctor.

Bai, 10~19 year old female. Ask Date: 2021/11/12

Dr. Zhang Junwei reply Neurosurgery

This is a traumatic subarachnoid hemorrhage, which usually can resolve on its own.

Reply Date: 2021/11/12

More Info

Understanding the recurrence risk of traumatic subarachnoid hemorrhage (SAH) is crucial for patients who have experienced head trauma. In your case, it appears that your SAH was caused by a head injury rather than a ruptured aneurysm, which significantly influences the risk of recurrence and the management of your symptoms.

Firstly, it’s important to clarify that traumatic SAH, like the one you experienced, typically arises from blunt force trauma to the head. This type of hemorrhage is different from SAH caused by a ruptured cerebral aneurysm, which is associated with a higher risk of recurrence. Since your CT scan indicated that the bleeding was limited and has since resolved, and you have no history of cerebral aneurysms, the likelihood of experiencing a recurrent SAH due to the initial trauma is low.

Regarding your ongoing symptoms of headaches and dizziness, it is not uncommon for patients who have experienced a traumatic brain injury (TBI) to develop post-traumatic headaches, which can manifest as migraines or tension-type headaches. These headaches can persist for weeks or even months following the injury. The good news is that many patients find that their symptoms improve over time. However, the recovery process can vary significantly from person to person. It is essential to follow up with your healthcare provider to discuss your symptoms and explore potential treatments, which may include medications, physical therapy, or lifestyle modifications.

As for engaging in vigorous physical activity, it is generally advisable to approach this with caution. While light to moderate exercise can be beneficial for recovery and overall health, high-impact activities or sports that pose a risk of head injury should be avoided until you have fully recovered and received clearance from your healthcare provider. It’s crucial to listen to your body; if you experience increased headache intensity or other concerning symptoms during or after exercise, you should stop and consult your doctor.

Long periods of cognitive activity, such as studying or working on mentally demanding tasks, can also exacerbate headaches in some individuals following a TBI. It is advisable to take regular breaks, manage stress, and ensure you are not overexerting yourself mentally. Gradually increasing your cognitive load as tolerated can help you gauge your limits.

In summary, while the risk of recurrence of SAH due to your head injury is low, ongoing headaches and dizziness are common after such trauma. With appropriate management and follow-up care, many individuals experience significant improvement in their symptoms over time. Always consult with your healthcare provider before making decisions about physical activity or if you have concerns about your recovery. They can provide personalized advice based on your specific situation and health history.

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