Even if life is saved, craniotomy and sequelae… “Breaking Down” subarachnoid hemorrhage “can happen anywhere!

It happens at the bar and at home.

An incident that occurred after the weigh-in the day before a match at the “Breaking Down” martial arts event is causing quite a stir. The incident occurred during the event’s famous pre-fight trash talk and brawl scene. During the post-weigh-in face-off, a player fainted and fell down due to a surprise slap. The diagnosis given at the hospital was subarachnoid hemorrhage.

It was not during the match, nor was a weapon used. It was a single slap and a subsequent fall that led to an irreversible situation.

This incident is not limited to the world of martial arts. The year-end and New Year’s parties are often filled with drinking. The same dangers lurk in the small fights, arguments, and light fights that occur in everyday life. Dr. Satoshi Ozaki, neurosurgeon and chairman of Ebina Neurology Clinic, sounds the alarm.

Subarachnoid hemorrhage is a disease in which bleeding occurs between the arachnoid membrane and the soft membrane that covers the surface of the brain. The hemorrhaged blood spreads all around the brain at once, causing sudden severe headache, disorientation, and vomiting. It is generally known to be caused by a ruptured cerebral aneurysm, but it can also be caused by trauma, i.e., the impact of a blow or fall.

If a person falls while fainting or suffering a concussion, he or she is unable to passively catch himself or herself and is struck hard on the back or side of the head.

Traumatic subarachnoid hemorrhage is more often caused by a hard blow to the head from a fall than by the impact of the blow itself. When a person faints, reflexes do not work. The head is struck as it is, and the brain is shaken violently inside the skull. The impact causes small blood vessels to break, resulting in hemorrhage. The conditions for this to happen are exactly the same, not only in martial arts, but also in drinking fights, street trouble, and domestic pushing and shoving.”

Even if he survives, he will suffer from aftereffects.

Dangerous cases are those in which “after a blow to the head, consciousness temporarily returns and no noticeable symptoms are seen. Because the patient appears to be able to talk and walk, both the patient and those around him or her tend to be reassured.

The scary thing about subarachnoid hemorrhage is that it is not always obvious immediately that the injury is serious. In some cases, the patient may appear normal on the spot but deteriorate rapidly a few hours later. Especially if the person has been drinking, the headache and lightheadedness coincide with drunkenness, and it is easy for abnormalities to be missed. This delay in judgment can be fatal.”

After a blow to the head, the person lies down and goes to sleep. Or, the people around him or her may judge that he or she is just sleeping and leave him or her alone. This can be fatal.

In the case of a patient with impaired consciousness after a head injury, it is sometimes difficult to tell whether the patient is asleep or has a decreased level of consciousness. In the meantime, bleeding may be progressing in the brain, and the decision to ‘wait and see until morning and let him rest a bit’ can make an irreversible difference.”

If any of the following symptoms are present, emergency medical attention is needed immediately, he says.

Headache that is stronger than anything you have ever experienced.
Repeated nausea or vomiting
Dimness of consciousness
Loss of fluency in all areas of the brain.
Difficulty moving a limb on one side.

At the hospital, we will first confirm the bleeding with CT. Traumatic subarachnoid hemorrhage is basically treated with bed rest and follow-up observation, but if there is a complication of acute subdural hematoma or cerebral contusion other than subarachnoid hemorrhage, craniotomy may be required.

Traumatic intracranial hemorrhage, including subarachnoid hemorrhage, is a disease that often leaves patients with aftereffects even if their lives are saved.

In many cases, patients suffer from impaired memory, concentration, and emotional dysregulation, making it impossible for them to return to work or their daily lives. Even if the hemorrhage is traumatic, this severity remains the same. Subarachnoid hemorrhage is a life-changing disease once it occurs.

Even a light-hearted fight, a single slap, or a single fall. That alone can change your life. I would like you to know this fact.”

During the year-end and New Year’s holidays, whether or not you can use reason to stop the moment when emotions and alcohol take precedence. That is the difference between saving your life.