How Long Should Patients Rest in Bed After Subarachnoid Hemorrhage?

Understanding Subarachnoid Hemorrhage and Its Risks

Subarachnoid hemorrhage (SAH) is a serious type of stroke caused by bleeding into the space surrounding the brain. Unlike other forms of hemorrhage, this condition involves blood accumulation in an area with minimal tissue support around blood vessels, making it highly unstable. This structural vulnerability significantly increases the risk of rebleeding, which can be life-threatening.

Why Immediate and Complete Rest Is Critical

Physical strain—even from simple actions like coughing forcefully, straining during bowel movements, or sudden emotional stress—can trigger a second bleed. For this reason, medical professionals strongly recommend complete bed rest during the initial recovery phase. Patients are typically advised to remain in absolute bed rest for approximately four weeks following the onset of symptoms.

During this period, any strenuous activity must be avoided. However, minor movements such as gentle turning or shifting positions in bed are permitted under supervision to prevent complications like bedsores or blood clots. The goal is to minimize fluctuations in blood pressure and intracranial pressure, both of which could jeopardize vascular stability.

Identifying the Underlying Cause: The Role of Aneurysms

In the majority of cases, subarachnoid hemorrhage results from the rupture of a cerebral aneurysm—a weak spot in a brain artery that balloons and bursts. Early diagnosis is crucial. Once SAH is confirmed, immediate imaging tests such as CT angiography or digital subtraction angiography are performed to detect the presence and location of an aneurysm.

If a ruptured aneurysm is identified, prompt intervention is essential. Endovascular coiling or embolization is often the preferred treatment method, where a catheter is used to insert coils into the aneurysm, sealing it off and preventing further bleeding.

Recovery Timeline After Aneurysm Treatment

Following successful embolization, the recovery path improves significantly. If post-operative evaluations show no signs of complications such as hydrocephalus (fluid buildup in the brain) or elevated intracranial pressure, patients may begin to mobilize as early as two weeks after the procedure.

Early ambulation is introduced gradually and carefully monitored. Physical therapy may be incorporated to help restore strength and coordination. However, full return to normal activities—including work, exercise, or heavy lifting—is usually delayed for several weeks or months, depending on individual progress and neurological stability.

Supportive Care and Long-Term Outlook

Besides strict bed rest and surgical intervention, comprehensive care includes managing blood pressure, preventing seizures with medication, and monitoring for vasospasm—a dangerous narrowing of brain arteries that can occur 5–10 days after the initial bleed.

With timely treatment and careful adherence to medical advice, many patients make a meaningful recovery. However, long-term follow-up is essential to monitor brain health, manage risk factors like hypertension, and reduce the likelihood of future cerebrovascular events.