How Long Do Patients Stay in the Hospital After a Subarachnoid Hemorrhage?

A subarachnoid hemorrhage (SAH) is a serious medical condition that requires prompt treatment and careful monitoring. The length of hospitalization varies significantly depending on the severity of the bleed, the underlying cause, and the patient's overall health. In mild cases, patients may be hospitalized for approximately 5 to 10 days. However, for more severe cases—especially those involving complications such as vasospasm or hydrocephalus—a hospital stay of several weeks to up to two months is not uncommon.

Understanding Subarachnoid Hemorrhage: Causes and Classification

Subarachnoid hemorrhage occurs when bleeding happens in the space between the brain and the thin tissues that cover it—the subarachnoid space. This condition can be life-threatening and typically demands immediate neurosurgical or neurological intervention. There are two primary categories of SAH: spontaneous and traumatic.

Spontaneous Subarachnoid Hemorrhage

The most common cause of spontaneous SAH is the rupture of an intracranial aneurysm—a weakened area in a brain artery that bursts under pressure. These events often occur without warning and can be triggered by factors like sudden physical exertion, high blood pressure, or emotional stress.

Symptoms are usually dramatic and include a sudden, severe headache often described as "the worst headache of my life," accompanied by nausea, vomiting, neck stiffness, and sometimes loss of consciousness. A non-contrast CT scan of the head is typically the first diagnostic step and can quickly confirm the presence of blood in the subarachnoid space.

Once bleeding is confirmed, further testing such as cerebral angiography (CTA or DSA) is essential to identify the source of the hemorrhage. In many cases, an aneurysm is found. Treatment options include endovascular coiling (embolization) or surgical clipping to prevent rebleeding. Both procedures require intensive postoperative care and monitoring in a specialized neuroscience intensive care unit (NICU).

Traumatic Subarachnoid Hemorrhage

This type of SAH results from head trauma, such as from falls, car accidents, or sports injuries. Even minor head impacts can lead to small vessel ruptures in the subarachnoid space. Unlike spontaneous SAH, traumatic cases are generally managed conservatively unless there are significant associated brain injuries.

Treatment focuses on symptom management, preventing secondary complications, and supporting recovery. Medications may include analgesics for pain, anticonvulsants if seizures are a risk, and drugs like nimodipine to reduce the chance of cerebral vasospasm. Blood pressure control and close neurological observation are also critical components of care.

Recovery and Hospitalization Timeline

For patients with mild SAH and no major complications, recovery may progress quickly, allowing discharge within a week or two. However, those with aneurysms requiring intervention or who develop delayed issues like vasospasm or hydrocephalus often need extended stays. Rehabilitation services, including physical therapy and cognitive support, may begin during hospitalization to promote long-term recovery.

In summary, while some individuals may only require a short hospital stay, others—particularly those with complex cases—may need prolonged care. Early diagnosis, appropriate treatment, and comprehensive follow-up are key to improving outcomes and reducing the risk of long-term disability.