“Game of Thrones” actress Emilia Clarke recently revealed she suffered a subarachnoid hemorrhage (SAH), a dangerous type of brain bleed, several years ago. Though often deadly, they can be successfully treated if caught early enough, as Clarke was fortunate to learn.
What is a SAH and What’s the Cause?
A subarachnoid hemorrhage is a type of bleed into the fluid spaces around the brain where the blood vessels are. When a SAH happens spontaneously, it’s most commonly caused by a ruptured aneurysm.
An aneurysm is an outpouching of a blood vessel caused by a weakness in the internal muscular layer of the vessel. The aneurysm expands like a balloon and the wall becomes weaker as it grows, subsequently rupturing.
Unfortunately, most brain aneurysms go undetected until they rupture. A large aneurysm can cause double or blurry vision, headaches, dizziness, or other neurologic symptoms by pressing on brain tissue or cranial nerves. If you experience these types of symptoms, seek medical attention immediately.
Some people may experience nausea and vomiting, and then go into a coma. For others, they may simply have the worst headache of their lives. It's important to be taken to a comprehensive stroke center with experts trained to care for this type of hemorrhage.
What Causes an Aneurysm?
Approximately 35 million people in the United States have aneurysms, but most aren’t having any symptoms. Around one percent of those aneurysms will go on to rupture.
Aneurysms usually form in adults, and after the age of 40. Although there are some families that have histories of them, aneurysms are predominantly spontaneous. Known risk factors for rupture of cerebral aneurysms include smoking and high blood pressure. Aneurysms can sometimes be associated with other conditions such as fibromuscular dysplasia, polycystic kidney disease, or infections.
Treatment for Aneurysms
If an aneurysm is identified after a rupture or SAH, the risk of re-rupture is very high and immediate treatment is usually recommended. If an aneurysm is discovered during the investigation of other unrelated symptoms, multiple factors go into the decision about how to manage it. The most important considerations include your age, as well as size, shape, and location of the aneurysm. Size and shape are the most important factors in predicting the risk of rupture. Unfortunately, there are no medications to prevent an aneurysm from rupturing.
If an aneurysm is small or deemed to have a very low risk of rupturing, your doctors may keep an eye on it with diagnostic angiography, CTA or MRA.
Once a decision is made to proceed with treatment, there are two options. One option is open surgical clipping. In this surgery, the aneurysm is exposed, and a titanium clip is placed across the neck of the aneurysm.
The second option is endovascular, or from inside the blood vessel — the type Emilia Clark experienced. Endovascular procedures go through the artery in the groin and involve sealing the aneurysm from inside the blood vessel. This procedure is most commonly done using small metal balls that fill the aneurysm so blood cannot enter it.
Expert Neurological Support is Here
Although treating aneurysms comes with risk, the potential of long-term disability after a rupture makes taking proactive, preventive action even more important. Should you ever find yourself facing this condition, your experienced care team will carefully consider your unique needs to help you make the best decisions for your long-term health.
Learn more about AdventHealth’s comprehensive neurological care by visiting our website.