Subarachnoid hemorrhage: how to treat?

Written by Zhang Hui
Neurology
Updated on September 04, 2024
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Subarachnoid hemorrhage, the most common cause of which is due to the rupture of an aneurysm. The rupture of an intracranial aneurysm leads to blood entering the subarachnoid space, causing corresponding clinical symptoms. Patients may experience severe headaches, nausea and vomiting, accompanied by significant restlessness, and may also develop complications such as cerebral vasospasm, hydrocephalus, which can be life-threatening. The treatment for subarachnoid hemorrhage mainly includes: First, it is recommended to promptly complete a full cerebral angiography. If an aneurysm is found, interventional embolization of the aneurysm may be administered. Second, the patient should be advised to rest in bed and maintain emotional stability. Some sedative medications should be given to the patient. Additionally, calcium channel blockers should be administered to prevent cerebral vasospasm. Furthermore, electrolyte disturbances must be corrected to prevent severe complications such as hydrocephalus.

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Written by Zhang Hui
Neurology
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Nursing Measures for Subarachnoid Hemorrhage

Subarachnoid hemorrhage is a rather dangerous disease that develops very quickly, causing severe headaches, nausea, vomiting in patients, and this disease has a high probability of bleeding, potentially causing some cerebral vasospasm, leading to secondary thrombus formation. Besides prompt treatment and identifying the cause, such as clipping an aneurysm, nursing measures are also very important. Common nursing measures mainly include: First, it is essential to educate the patient to stay in bed and rest absolutely, as premature activity may cause the aneurysm to rupture and rebleed. Second, the patient must be instructed to maintain smooth bowel movements and a stable emotional state to prevent increased intracranial pressure and rebleeding due to emotional excitement or constipation. Third, the patient should be encouraged to drink more water and be given sufficient fluids to prevent cerebral vasospasm and low perfusion effects. Other nursing measures include stabilizing the patient's mood and providing sedation when necessary.

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Written by Liu Yan Hao
Neurology
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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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Written by Wei Shi Liang
Intensive Care Unit
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Symptoms and signs of subarachnoid hemorrhage

The typical symptoms of subarachnoid hemorrhage include headache, vomiting, and sudden severe pain, accompanied by vomiting, pale complexion, and whole-body cold sweats. Additionally, there may be disturbances in consciousness and psychiatric symptoms. Most patients do not experience disturbances in consciousness, but may exhibit restlessness and agitation. Severe cases can show varying degrees of clouded consciousness, and even coma, with a few instances displaying seizures and psychiatric symptoms. Furthermore, signs of meningeal irritation are also present, particularly common and pronounced in young and middle-aged patients, characterized by neck stiffness, headaches, and vomiting.

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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 Zhang Hui
Neurology
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Complications of subarachnoid hemorrhage

Subarachnoid hemorrhage is a very dangerous disease primarily caused by the rupture of the meninges or blood vessels at the base of the skull, leading to blood entering the subarachnoid space. Clinically, the most common cause is an aneurysm, but it can also occur with some arteriovenous malformations. Subarachnoid hemorrhage can cause severe headaches, nausea, vomiting, and other complications, with severe cases leading to coma. Common complications of subarachnoid hemorrhage include, firstly, rebleeding. The probability of rebleeding is very high, and if it occurs, the disability and mortality rates of the patient significantly increase. Secondly, cerebral vasospasm, which is an important complication that can lead to severe cerebral thrombosis due to intense constriction of the blood vessels. Thirdly, it can cause secondary hyponatremia, leading to electrolyte imbalance. Additionally, complications of subarachnoid hemorrhage include increased intracranial pressure, hydrocephalus, and more.