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 Liu Yan Hao
Neurology
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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.)

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Written by Chen Yu Fei
Neurosurgery
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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.

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Written by Zhang Hui
Neurology
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Symptoms of subarachnoid hemorrhage

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 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 Zhang Hui
Neurology
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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.