Subarachnoid hemorrhage: how to treat?

Written by Zhang Hui
Neurology
Updated on September 04, 2024
00:00
00:00

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.

Other Voices

doctor image
home-news-image
Written by Zhang Hui
Neurology
1min 11sec home-news-image

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.

doctor image
home-news-image
Written by Wang Li Bing
Intensive Care Medicine Department
52sec home-news-image

Subarachnoid hemorrhage should go to which department?

Subarachnoid hemorrhage is also relatively common in clinical settings. Its symptoms primarily include severe headaches, reflex vomiting, possible consciousness disturbances, and even seizures. Following the occurrence of subarachnoid hemorrhage, a cranial CT scan can be used for a definitive diagnosis. Patients typically seek treatment in neurology or neurosurgery departments. After admission to a neurology ward, DSA (Digital Subtraction Angiography) can be conducted to accurately locate the bleeding site, and interventional embolization treatments may be considered. If the patient has a large volume of subarachnoid hemorrhage, neurosurgery might be considered for the removal of intracranial hematomas or decompressive craniectomy, among other procedures.

doctor image
home-news-image
Written by Zhang Hui
Neurology
53sec home-news-image

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.

doctor image
home-news-image
Written by Zhang Hui
Neurology
1min 8sec home-news-image

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.

doctor image
home-news-image
Written by Chen Yu Fei
Neurosurgery
1min 1sec home-news-image

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.