Symptoms of subarachnoid hemorrhage

Written by Zhang Hui

Neurology

Updated on September 01, 2024

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Subarachnoid hemorrhage is a rather dangerous disease, generally caused by the rupture of an aneurysm, but it can also be due to cerebral arteriovenous malformations. The symptoms of the hemorrhage mainly manifest as severe headache, with many patients describing it as the worst headache of their life. Additionally, patients may experience significant nausea and vomiting, and signs of meningeal irritation such as neck stiffness. Patients with subarachnoid hemorrhage may also develop a fever, though typically not exceeding 38 degrees Celsius, and may experience cerebral vasospasms. If the spasms are severe, they could lead to secondary cerebral thrombosis. Moreover, if the bleeding is substantial, the patient may also suffer from consciousness disorders such as coma, as well as serious complications like electrolyte imbalances and hyponatremia.

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Written by Liu Yan Hao

Neurology

1min 18sec

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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.

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Written by Tang Bo

Neurology

50sec

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Is subarachnoid hemorrhage considered a minor injury?

Subarachnoid hemorrhage depends on the amount of bleeding and the location to determine the severity of the condition. It can be life-threatening in severe cases. If symptoms such as headache and severe vomiting occur, the possibility of subarachnoid hemorrhage should be considered. Initially, a cranial CT scan should be conducted to confirm the diagnosis. Further investigations should include cranial MRI or CTA vascular imaging, preferably CTA, to determine whether there is rupture bleeding caused by an aneurysm. In such cases, it is necessary to consider whether emergency surgery is required, based on the amount of bleeding and the condition of the blood vessels, and the possibility of an aneurysm to guide further treatment.

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Written by Zhang Hui

Neurology

1min 11sec

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Differentiation between subarachnoid hemorrhage and cerebral hemorrhage

Subarachnoid hemorrhage and cerebral hemorrhage, though both involve bleeding, have different mechanisms of onset. The first distinction is that cerebral hemorrhage is generally caused by hypertension. Hypertension leads to hyaline degeneration and fibrinoid necrosis of arteries, resulting in bleeding. In contrast, the most common cause of subarachnoid hemorrhage is an aneurysm, which may be related to factors such as smoking and congenital developmental abnormalities. In terms of clinical presentation, cerebral hemorrhage has a sudden onset, with symptoms of headache, nausea, vomiting, but also includes impairments in language functions, and signs of neurological deficits such as limb paralysis. Subarachnoid hemorrhage, on the other hand, typically involves very severe pain, usually without manifestations such as limb paralysis. Furthermore, from a radiological perspective on CT imaging, cerebral hemorrhage is mainly located in the brain parenchyma, while subarachnoid hemorrhage mainly indicates that the site of bleeding is in the subarachnoid space.

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Written by Zhang Hui

Neurology

53sec

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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.

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Written by Chen Yu Fei

Neurosurgery

1min 1sec

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The difference between cerebral hemorrhage and subarachnoid hemorrhage

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.