The difference between cerebral hemorrhage and subarachnoid hemorrhage

Written by Chen Yu Fei
Neurosurgery
Updated on September 27, 2024
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There is a significant difference between cerebral hemorrhage and subarachnoid hemorrhage. For subarachnoid hemorrhage, the specific causes are mainly divided into two types. The first cause is due to trauma, violent strikes, car accidents, or falls from heights, leading to localized vascular rupture and extensive subarachnoid hemorrhage. It generally presents as obvious high-density shadows in the ventricular system or cisterns. The occurrence of subarachnoid hemorrhage often leads to symptoms such as headache, dizziness, neck stiffness, and positive meningeal irritation signs. The other situation is spontaneous subarachnoid hemorrhage, most often due to intracranial aneurysms or arteriovenous malformations. Cerebral hemorrhage is primarily due to hypertensive cerebral hemorrhage, which is more likely to occur, mostly seen in the bilateral basal ganglia, presenting as localized high-density shadows.

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Written by Li Ai Ping
Neurology
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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.

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Written by Wang Li Bing
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Clinical manifestations of subarachnoid hemorrhage

The main clinical manifestations of subarachnoid hemorrhage are sudden severe headache, accompanied by nausea and vomiting, with positive signs of meningeal irritation. If such symptoms occur, it is urgent to seek medical attention and perform a cranial CT scan. If the CT shows a high-density shadow in the subarachnoid space, it can be diagnosed as subarachnoid hemorrhage, and the patient should be treated in neurology or neurosurgery for active management. Clinically, conservative medication treatment is generally adopted, paying attention to changes in the patient's consciousness and pupils, and surgical treatment may be considered if necessary.

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Written by Zhang Hui
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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.

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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.

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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.