Brain injury (SAH)

There are many different ways in which the brain can suffer injury. One of these is subarachnoid haemorrhage or SAH: "an uncommon type of stroke caused by bleeding on the surface of the brain. It's a very serious condition and can be fatal." (NHS) 

When my partner was rushed into surgery with her first SAH the doctors sat me down to tell me the following: 

SAH is a severe condition — half of people who have subarachnoid hemorrhage experience sudden death. Of those who make it to a hospital:

• One-third die in the hospital.
• One-third survive with disability.
• One-third return to their normal function

That is quoted from Cleveland Clinic but is almost word for word what I was told. Cleveland defines subarachnoid hemorrhage* as "bleeding in the space below one of the thin layers that cover and protect your brain." Apparently, and somewhat paradoxically, while the flow of blood to the brain is what makes it work and keeps us alive, but blood outside of the proper channels can severely damage brain cells and cause death. 

Rapid response to an SAH is vital because the sooner a bleed can be stopped, the less damage the blood will do. As Cleveland Clinic notes: "SAH is a medical emergency that requires immediate treatment. It’s often caused by head trauma and/or a ruptured brain aneurysm." 

So, a motor traffic accident or physical assault can cause an SAH, but they can also happen randomly and without warning or physical trauma if a blood vessel in your head bursts in the wrong place. In such cases, as Cleveland puts it, "the most common sign is a sudden, severe headache." (My partner has had two SAH due to ruptured brain aneurysms and both manifested as massive head pain in the middle of the night that quickly got so bad bad she was immobilized and incoherent.

The multiple causes of SAH are reflected in two brain injury terms you may encounter: Traumatic Brain Injury or TBI, and Acquired Brain Injury (ABI). Both can lead to brain damage, the manifestations of which are many and varied. An SAH is also consider a form of stroke and a type of brain haemorrhage or brain bleed. Here are some of the problems that such things can cause: 

• Cognitive dysfunction: difficulties with one or more brain functions, such as memory; problems with tasks that require some degree of planning 
• Emotional problems: depression, anxiety disorder, post-traumatic stress disorder (PTSD)
• Epilepsy
• Fatigue

*Americans drop the "a" in blood words like haemorrhage and haemocromatosis.