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Subarachnoid hemorrhage
Subarachnoid hemorrhage causes increased intracranial pressure.
Patients with subarachnoid hemorrhage often have very high intracranial pressure. The main reason for the rise in intracranial pressure is that after the hemorrhage, the bloody cerebrospinal fluid usually stimulates nerves and blood vessels within the brain, which can lead to edema, such as vascular edema and neural edema, thereby gradually increasing the intracranial pressure. Sometimes, and relatively infrequently, the increase in cranial pressure is not significant. However, if the volume of subarachnoid hemorrhage is very large, the intracranial pressure can rise substantially, leading to symptoms like severe nausea, vomiting, and headache, and in severe cases, there can be significant disturbances in consciousness. Additionally, patients with subarachnoid hemorrhage may sometimes experience obstructive or communicating hydrocephalus, which can also lead to increased cranial pressure.
Is it normal to have a fever with subarachnoid hemorrhage?
It is normal for patients with subarachnoid hemorrhage to develop a fever, but this must be assessed in conjunction with the patient’s body temperature and overall condition. Sometimes, the amount of bleeding in the subarachnoid space is small and may cause mild fever, mainly due to the irritation of the nerves by bloody cerebrospinal fluid. In other cases, when there is a lot of bleeding, it may cause high fever, possibly central fever, which requires specific measures to reduce the body temperature, such as pharmacotherapy, applying ice packs, or using hypothermia therapy devices. Additionally, some patients develop a fever three to five days after the subarachnoid hemorrhage, which might indicate a secondary infection, such as lung or urinary tract infections, necessitating anti-infection treatment.
Subarachnoid hemorrhage nausea and vomiting how to treat
Patients with subarachnoid hemorrhage experiencing nausea and vomiting can still be treated. Firstly, symptomatic treatment should be conducted, which can include using gastric mucosal protectants and antiemetic medications to effectively alleviate symptoms. Additionally, subarachnoid hemorrhage, nausea, and vomiting are often caused by increased intracranial pressure. In such cases, using mannitol or furosemide to dehydrate can reduce intracranial pressure. Once the intracranial pressure decreases, the symptoms of nausea and vomiting can be greatly improved and alleviated. Of course, some patients may also have complications such as hydrocephalus or intracerebral hematoma. In these cases, surgical interventions like craniotomy for hematoma removal or aneurysm clipping may be necessary, which can gradually relieve and improve the symptoms of nausea and vomiting. Beyond symptomatic treatment, it is also necessary to treat the underlying primary disease, addressing causes such as aneurysms or vascular malformations.
Is there a cure for secondary bleeding in subarachnoid hemorrhage?
This needs to be specifically analyzed based on the patient's condition. In most cases, a second subarachnoid hemorrhage is often very severe and generally considered beyond recovery. The patient is likely to die or, even if their life is saved, they may suffer from serious sequelae. They may remain in a prolonged coma, exist in a vegetative state, or suffer from severe impairments that prevent them from caring for themselves. However, some patients are luckier. With a second or third subarachnoid hemorrhage that is not very severe, if it is recognized early and treated promptly, and if the primary diseases are managed and aneurysms are treated with embolization or craniotomy for clipping, the outcomes can be favorable. In such cases, complete recovery is possible, and the patient can be saved.
Subarachnoid hemorrhage clinical manifestations
Patients with subarachnoid hemorrhage typically exhibit persistent, severe headaches accompanied by projectile vomiting. Patients often experience symptoms of clouded consciousness, irritability, and anxiety. The most common cause of subarachnoid hemorrhage is the rupture of cerebral aneurysms, with blood entering the subarachnoid space, stimulating the pia mater and arachnoid membrane, and inducing severe headaches. This also leads to a rapid increase in intracranial pressure, causing projectile vomiting. Additionally, symptoms often include clouded consciousness and restlessness. Treatment requires complete bed rest for four to six weeks, using hemostatic, analgesic, and sedative medications to allow the patient to rest quietly. (Use specific medications only under the guidance of a doctor, and do not self-medicate.)
Clinical manifestations of subarachnoid hemorrhage
The clinical manifestations of subarachnoid hemorrhage include severe headache, projectile vomiting, and neck stiffness, sometimes accompanied by disturbances in consciousness. Some describe the headache caused by subarachnoid hemorrhage as the most severe headache of their lives. This severe pain is due to the congestion stimulating the meninges, causing pain that is typically very severe. Because the bleeding into the subarachnoid space allows blood to enter between the pia mater and the arachnoid membrane, stimulating the meninges and leading to these severe headaches, it causes a rapid increase in intracranial pressure and projectile vomiting. Patients may exhibit disturbances in consciousness and symptoms of irritability. This condition is considered a severe medical emergency that requires hospitalization for comprehensive treatment, with strict bed rest for four to six weeks, and it has a very high mortality rate.
Subarachnoid hemorrhage MR manifestations
Subarachnoid hemorrhage is typically visible on an MR scan, where blood presence can be detected in the cerebral sulci. MR stands for Magnetic Resonance, and it offers various scanning sequences such as T1, T2, diffusion imaging, and fluid-attenuated inversion recovery (FLAIR). Although it may sound complex, these sequences can show high signals in areas of the brain sulci where normally there should be no distinctive signals or colors. After a subarachnoid hemorrhage, these areas show up as brightly lit on the images. Hence, magnetic resonance imaging is particularly sensitive to even small amounts of subarachnoid hemorrhage, especially noticeable in the diffusion imaging sequences where these bright signals are prominently visible.
Postoperative care for subarachnoid hemorrhage
For patients recovering from subarachnoid hemorrhage, a critical aspect of care is to prevent emotional excitement and avoid any exertion initiated by the patients themselves. This includes avoiding forceful movements such as turning over or straining during bowel movements, which are not permitted. Patients must rest in bed absolutely, for four to six weeks. Therefore, during nursing, it is important to assist patients with passive movements, such as turning them over every two hours to gently pat their backs. The purpose of patting the back is to effectively prevent the occurrence of dependent pneumonia, while turning them helps prevent pressure sores. Additionally, assistance can be provided for passive limb movements and massaging the limbs, which can effectively prevent the formation of venous thrombosis in the lower or upper limbs. These are the focal points of nursing that can significantly promote the patient's recovery from their condition.
What to do with a headache from subarachnoid hemorrhage?
Subarachnoid hemorrhage, the most typical symptom of which is headache, often manifests as a sudden severe throbbing or bursting pain. The pain may be localized to a specific area of the head, or it may affect the entire head or neck, and it generally persists continuously. If such a headache occurs, one should first rest in bed, avoid emotional excitement and exerting great force, such as coughing, shouting loudly, or straining during bowel movements, etc. If the pain is unbearable, one can ask a doctor for appropriate pain relief medication. However, if the headache suddenly worsens, one should be cautious of the condition deteriorating and should seek medical advice to investigate the cause of the worsening headache. One should not blindly request medication for pain relief, as it may mask the underlying condition.
Subarachnoid hemorrhage is caused by what?
The most common cause of subarachnoid hemorrhage is the rupture of a cerebral aneurysm. The subarachnoid space is located on the surface of the brain, surrounded by three layers of meninges: from inner to outer, they are the pia mater, arachnoid mater, and dura mater. The space between the pia mater and arachnoid mater is known as the subarachnoid space. Following the rupture of a cerebral aneurysm, blood enters this subarachnoid space, leading to hemorrhage. Subarachnoid hemorrhage is a critical condition in internal medicine, with a relatively high mortality rate. The most common cause is a cerebral aneurysm, and patients who have suffered a subarachnoid hemorrhage should undergo brain MRI and vascular imaging to check for the presence of cerebral aneurysms or vascular abnormalities. If a cerebral aneurysm is present, it needs to be treated promptly. Typical interventions include placing a coiling spring to close off the aneurysm, preventing it from rupturing and thus averting a secondary subarachnoid hemorrhage, which has a mortality rate as high as 50%. Another common cause of subarachnoid hemorrhage is brain trauma, which is also a frequent cause of this condition.