Stretching the Limits: Unexpected Subarachnoid Hemorrhage During Yoga

Stretching the Limits: Unexpected Subarachnoid Hemorrhage During Yoga | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Case Report Stretching the Limits: Unexpected Subarachnoid Hemorrhage During Yoga Abdullah Bokhari, DO, Andrew Vierra, Leena Jamal, Mrinal Sinha This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7469008/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Abstract Background: Subarachnoid hemorrhage (SAH) is a rare but life-threatening condition usually caused by rupture of an intracranial aneurysm. Nontraumatic spontaneous SAH triggered by sudden movement is exceedingly rare. Case: We present a 45-year-old female who developed acute-onset diffuse headache and unilateral hearing loss following sudden movement during yoga after being startled by a spider. Imaging revealed diffuse subarachnoid hemorrhage involving the suprasellar cisterns, basilar cisterns, fourth ventricle, and upper cervical spine. Discussion: This case highlights the unusual mechanism of SAH following abrupt head movement without direct trauma. Awareness of atypical SAH presentations is critical in emergency settings. Conclusion: Even low-impact events may precipitate catastrophic vascular events in susceptible individuals, reinforcing the importance of thorough assessment in patients with acute neurologic symptoms after minor physical activities. Introduction Subarachnoid hemorrhage (SAH) represents 5-10% of all strokes and carries a mortality rate up to 50% [1]. The majority of SAHs result from rupture of saccular aneurysms; trauma accounts for a smaller proportion. Classical presentation includes a sudden “thunderclap” headache, often accompanied by nausea, vomiting, nuchal rigidity, and altered mental status [1-3]. Cases involving SAH triggered by non-traumatic sudden movement, particularly during activities like yoga, are exceedingly rare. Proposed mechanisms include abrupt increases in intracranial pressure and mechanical vessel stress [4,5]. We present a unique case where a sudden jump during yoga induced a spontaneous SAH, emphasizing the need for vigilance even in seemingly benign situations and occurrences. Critical Care & Emergency Medicine Emergency medicine Neurology Stroke < Neurology Full Text Additional Declarations I declare that the patient consented and agreed to allow her case for publication. The authors declare no competing interests. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7469008","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Case Report","associatedPublications":[],"authors":[{"id":506224493,"identity":"27e9fbf1-dea0-4661-ad66-02c432bb3ca4","order_by":0,"name":"Abdullah Bokhari, DO","email":"data:image/png;base64,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","orcid":"","institution":"","correspondingAuthor":true,"prefix":"","firstName":"DO","middleName":"Abdullah","lastName":"Bokhari","suffix":""},{"id":506224640,"identity":"521a9349-9cb5-44d8-9a5d-6bd26dd41c22","order_by":1,"name":"Andrew Vierra","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Andrew","middleName":"","lastName":"Vierra","suffix":""},{"id":506224641,"identity":"71b5e418-8ae9-46db-845f-ea5013b22c53","order_by":2,"name":"Leena Jamal","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Leena","middleName":"","lastName":"Jamal","suffix":""},{"id":506224642,"identity":"94163b4f-6735-4b2e-b5b6-0cea461ebc44","order_by":3,"name":"Mrinal Sinha","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Mrinal","middleName":"","lastName":"Sinha","suffix":""}],"badges":[],"createdAt":"2025-08-27 07:41:32","currentVersionCode":1,"declarations":{"humanSubjects":false,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":false,"humanSubjectConsent":false,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-7469008/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7469008/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":90282590,"identity":"a12aead4-a1f9-4256-a6d4-531426d0e7d2","added_by":"auto","created_at":"2025-09-01 05:14:00","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":265705,"visible":true,"origin":"","legend":"","description":"","filename":"bcr2025268854Proofhi.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7469008/v1_covered_8f73da27-6c47-48d2-98cc-e40a186be458.pdf"}],"financialInterests":"\u003cp\u003eI declare that the patient consented and agreed to allow her case for publication.\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e","formattedTitle":"\u003cp\u003eStretching the Limits: Unexpected Subarachnoid Hemorrhage During Yoga\u003c/p\u003e","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"McLaren Health Care","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Emergency medicine, Neurology, Stroke \u003c Neurology","lastPublishedDoi":"10.21203/rs.3.rs-7469008/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7469008/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eAbstract Background: Subarachnoid hemorrhage (SAH) is a rare but life-threatening condition usually caused by rupture of an intracranial aneurysm. Nontraumatic spontaneous SAH triggered by sudden movement is exceedingly rare. Case: We present a 45-year-old female who developed acute-onset diffuse headache and unilateral hearing loss following sudden movement during yoga after being startled by a spider. Imaging revealed diffuse subarachnoid hemorrhage involving the suprasellar cisterns, basilar cisterns, fourth ventricle, and upper cervical spine. Discussion: This case highlights the unusual mechanism of SAH following abrupt head movement without direct trauma. Awareness of atypical SAH presentations is critical in emergency settings. Conclusion: Even low-impact events may precipitate catastrophic vascular events in susceptible individuals, reinforcing the importance of thorough assessment in patients with acute neurologic symptoms after minor physical activities. Introduction Subarachnoid hemorrhage (SAH) represents 5-10% of all strokes and carries a mortality rate up to 50% [1]. The majority of SAHs result from rupture of saccular aneurysms; trauma accounts for a smaller proportion. Classical presentation includes a sudden “thunderclap” headache, often accompanied by nausea, vomiting, nuchal rigidity, and altered mental status [1-3]. Cases involving SAH triggered by non-traumatic sudden movement, particularly during activities like yoga, are exceedingly rare. Proposed mechanisms include abrupt increases in intracranial pressure and mechanical vessel stress [4,5]. We present a unique case where a sudden jump during yoga induced a spontaneous SAH, emphasizing the need for vigilance even in seemingly benign situations and occurrences.\u003c/p\u003e","manuscriptTitle":"Stretching the Limits: Unexpected Subarachnoid Hemorrhage During Yoga","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-01 05:05:54","doi":"10.21203/rs.3.rs-7469008/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"f5edf690-49ab-4022-afe2-081637828823","owner":[],"postedDate":"September 1st, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":53768076,"name":"Critical Care \u0026 Emergency Medicine"}],"tags":[],"updatedAt":"2025-09-01T05:05:54+00:00","versionOfRecord":[],"versionCreatedAt":"2025-09-01 05:05:54","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7469008","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7469008","identity":"rs-7469008","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}