Subscribe
Subarachnoid hemorrhage
Subarachnoid hemorrhage examination methods
Subarachnoid hemorrhage is also relatively common in clinical practice. Patients may experience severe headaches, nausea, and projectile vomiting. The clinical signs generally include positive meningeal irritation signs, typically presenting with neck stiffness, Kernig's sign, and Brudzinski's sign all being positive. Clinically, the diagnosis can be confirmed mainly through cranial CT scans. If conditions permit, lumbar puncture can be performed to ascertain the nature of the cerebrospinal fluid and the intracranial pressure, etc. After a subarachnoid hemorrhage occurs, patients should be admitted to the neurology department for active treatment, and typically receive dehydration therapy to reduce intracranial pressure and neuroprotection among other symptomatic treatments.
subarachnoid hemorrhage CT manifestations
Subarachnoid hemorrhage often occurs spontaneously and due to trauma. Spontaneous subarachnoid hemorrhages are usually caused by the rupture of an aneurysm. They have relatively obvious manifestations on CT, appearing as increased columnar strip densities in areas like the suprasellar cistern, quadrigeminal cistern, cerebellar tent, falx cerebri, and lateral fissure pools, as well as strip-like high density shadows within the cerebral sulci and gyri. If the subarachnoid hemorrhage is traumatic, the CT manifestations are generally mild, potentially only showing local fuzziness of the cerebral septum. At the same time, there may also be brain contusion-laceration injuries, such as extradural hematoma, subdural hematoma, and skull fractures.
Subarachnoid hemorrhage drainage surgery
Subarachnoid hemorrhage drainage, also known as cerebrospinal fluid replacement surgery, often occurs due to the rupture of cerebral aneurysms. The blood clots enter the subarachnoid space causing severe headaches, increased intracranial pressure, nausea, vomiting, and other symptoms. It is essential to drain the blood clots as early as possible to achieve effective treatment results. The subarachnoid space is a gap between the pia mater and arachnoid mater, which are two of the three membranes covering the brain and spinal cord—the innermost layer being the pia mater, followed by the arachnoid and the outermost dura mater. Normally, the subarachnoid space contains cerebrospinal fluid that is continuously circulating. Hence, in patients with subarachnoid hemorrhage, performing a lumbar puncture can drain the bloody cerebrospinal fluid. During this procedure, a puncture is made in the lumbar region to drain the bloody cerebrospinal fluid, followed by the injection of an equal volume of saline solution. This facilitates the replacement of the blood clots in the subarachnoid space with saline solution. Conducting this procedure once daily, continuously for three to five days, can significantly alleviate the symptoms of subarachnoid hemorrhage. Essentially, this process is also known as cerebrospinal fluid puncture or cerebrospinal fluid replacement surgery.
Is subarachnoid hemorrhage hereditary?
Subarachnoid hemorrhage occurs due to the rupture of intracranial blood vessels and the subsequent leaking of blood into the subarachnoid space. In most cases, this condition is caused by the rupture of an aneurysm. This disease does not have a significant genetic predisposition, so there is no need for excessive worry. The common causes of this disease are primarily intracranial aneurysms, followed by vascular malformations. It should be noted that arteriosclerosis can also lead to the formation of aneurysms, and long-term smoking can also cause aneurysms. Subarachnoid hemorrhage often begins abruptly, and the patient might be engaged in some physical activity or experiencing fluctuating emotions when suddenly severe headache, nausea, vomiting, and even consciousness disturbances occur. It is essential to treat a subarachnoid hemorrhage as soon as possible.
Subarachnoid hemorrhage sequelae
Subarachnoid hemorrhage is a rather dangerous disease that develops very suddenly, most often caused by the rupture of an intracranial aneurysm. Some patients may not have any sequelae, but some severe cases can result in lasting consequences. Common sequelae include the following aspects: First, hydrocephalus. This condition can lead to adhesions of the meninges and can cause blood to remain in the subarachnoid space and the ventricles, potentially causing fluid accumulation. Second, there may be residual epileptic seizures. If epilepsy is a sequela, long-term oral anti-epileptic drugs are required. Third, some patients may experience cerebral vasospasm, leading to secondary cerebral infarction, which can leave patients with limb paresis and language impairments.
Does subarachnoid hemorrhage require surgery?
Whether subarachnoid hemorrhage requires surgery depends on the specific circumstances, as there are many causes of subarachnoid hemorrhage, commonly caused by aneurysms. Therefore, the decision to perform surgery is based on the size of the aneurysm and the amount of bleeding, as well as the patient’s overall condition to determine if they can tolerate surgery. Additionally, some subarachnoid hemorrhages may be caused by arteriovenous malformations or other reasons. The decision whether to opt for surgery or conservative treatment also depends on the amount of bleeding and the patient's symptoms, and the risk involved is relatively high.
How long is the recovery period for subarachnoid hemorrhage?
The recovery period for subarachnoid hemorrhage is four to six weeks, during which absolute bed rest is theoretically required. Subarachnoid hemorrhage is a severe emergency in internal medicine with a very high mortality rate. Common causes of subarachnoid hemorrhage include cerebral vascular malformation, cerebral aneurysm, and rupture of blood vessels into the subarachnoid space, causing various symptoms. The main symptoms include severe headache, increased intracranial pressure, nausea, and vomiting. There are three layers of meninges in the subarachnoid space, consisting of the pia mater, arachnoid mater, and dura mater. Between the pia mater and the arachnoid mater is the subarachnoid space. Following a subarachnoid hemorrhage, a large amount of blood enters the subarachnoid space, leading to increased intracranial pressure, which can cause cerebral edema, brain cell death, and even brain herniation, potentially compressing the respiratory control center and leading to death. Without proper treatment, the mortality rate of a second subarachnoid hemorrhage can reach up to 50%, and for a third subarachnoid hemorrhage, survival is almost impossible with the mortality rate nearly 100%.
Complications of subarachnoid hemorrhage
Subarachnoid hemorrhage is a relatively serious condition. Most patients suffer from this due to the rupture of an aneurysm, while others may have arteriovenous malformations. This disease is associated with complications, with common ones including the following. First, there are acute complications of subarachnoid hemorrhage. Patients usually experience severe pain and vomiting again after their condition stabilizes, and the mortality rate significantly increases. The second complication is cerebral vasospasm, which typically peaks between three days and two weeks. Cerebral vasospasm can easily lead to vascular occlusion and the subsequent formation of cerebral thrombosis. The third type includes acute or subacute hydrocephalus. Additionally, seizures and electrolyte disorders may also occur as complications.
Causes of subarachnoid hemorrhage
Subarachnoid hemorrhage is a very dangerous disease, in which patients experience severe headaches, noticeable nausea, vomiting, restlessness, and agitation. If the bleeding is extensive, the patient can quickly become comatose and may develop serious complications such as cerebral vasospasm and hydrocephalus. Common causes of cerebral hemorrhage include: First, cerebral aneurysms. Cerebral aneurysms are the most common cause of subarachnoid hemorrhage and may be related to congenital developmental abnormalities or acquired factors such as smoking. Second, arteriovenous malformations, which are also a common cause of bleeding. Third, there are other causes, such as trauma or coagulation disorders, and long-term use of anticoagulant medications may also be contributing factors.
Subarachnoid Hemorrhage CT Imaging Manifestations
Subarachnoid hemorrhage is caused by the rupture of cerebral blood vessels due to various reasons, allowing blood to flow into the subarachnoid space. Common causes include trauma and rupture of congenital aneurysms. Subarachnoid hemorrhage caused by the rupture of congenital aneurysms typically presents on a CT scan with high-density appearances at the base of the skull in the brain pools, especially widespread columnar high-density appearances in the suprasellar cistern, lateral fissure cistern, anterior interhemispheric fissure, and around the circumferential pool. If the subarachnoid hemorrhage is due to trauma, the abnormalities are more localized, generally appearing in the brain pool or cerebral sulcus on the side of injury with high-density appearances, and may also be accompanied by hematomas within the ventricles or bleeding in other locations.