SAH in adults has a couple of factors that may lead to a higher risk. These include alcohol abuse, cigarette smoking, and high blood pressure. A reduction in the exposure to these factors may contribute to much better health and a lower incidence of the condition.
As far as children are involved, however, the SAH risk factors are a bit more difficult to determine and to control.
Risk Factors in Children
Cardiovascular malformations, tumors, and hematological abnormalities rank among the common SAH risk factors in children.
Statistics suggest that arteriovenous malformations account for 14 percent of the hemorrhagic strokes in children. Hematological abnormalities are an even more prominent risk factor. These account for anywhere between 10 and 30 percent of the hemorrhagic strokes in children.
Certain kinds of intracranial hemorrhages are more common among premature babies. SAH isn’t typically one of those. A baby being born pre-term could be one of the factors that will eventually contribute to brain bleeding, but the hemorrhage is usually of another variety.
SAH tends to be more common among full-term rather than premature babies. If this is the case, a few prominent risk factors will have to be taken into consideration. One study suggests that two of these happen to be much more frequent than all others. Traumatic delivery, and severe hypoxic-ischemic encephalopathy are these two factors.
Here’s a comprehensive list of all possible conditions and circumstances that may contribute to SAH:
- Traumatic delivery: a delivery that lasts too long or that involves the use of instruments can potentially increase the risk of SAH significantly.
- Forceps assistance is a particularly prominent risk factor. According to one study, forceps assistance was the biggest cause of brain hemorrhage in a control group of 104 full-term babies.
- A low platelet count, hemophilia, a vitamin K deficiency
- Changes in the baby’s blood pressure
- A baby that’s too big to pass through the mother’s pelvis effortlessly
- Hypoxic ischemic encephalopathy - a very dangerous condition that’s characterized by low levels of oxygen that could potentially contribute to a brain injury. When this condition occurs near or at the time of delivery, it may cause blood vessels to rupture, and it will increase the risk of subarachnoid hemorrhages.
Children born in families that have a history of aneurysms are also more likely to have a higher than average risk of developing a subarachnoid hemorrhage.
On top of these relatively common factors, there are a few more that occur less frequently. Certain medical conditions may lead to a weakening of the blood vessels, making them easier to rupture. Some of these conditions include polycystic kidney disease, connective tissue disorders, and fibromuscular dysplasia.
Recognizing the Signs and Symptom
Recognizing the symptoms of a subarachnoid hemorrhage is incredibly important, especially when it comes to stabilizing the newborn and reducing the risk of a larger bleeding.
Diagnostic imaging is recommended for the children that have one or more of the risk factors. If forceps delivery has occurred, for example, a diagnostic head scan may be recommended to make sure that SAH hasn’t occurred.
In other cases, it would be essential to remain observant and identify the symptoms of SAH upon their onset.
A few of the most common symptoms include:
- Weakness, lethargy and slow reflexes
- Vision loss
- Neck stiffness
- Intense crying that doesn’t seem to be calmed by anything
- Feeding difficulties
- Strained and difficult breathing
- An altered consciousness level
While there isn’t an awful lot that can be done upon diagnosing a subarachnoid hemorrhage, medics still have options for stabilizing and supporting the newborn. If the condition becomes aggravated, surgical management may become necessary. A surgeon can drain some of the cerebrospinal fluid and blood to reduce the intracranial pressure. High intracranial pressure due to the accumulation of blood is one of the most serious risk factors for neurological complications resulting from SAH.