Is subarachnoid hemorrhage considered a minor injury?

Written by Tang Bo
Neurology
Updated on September 04, 2024
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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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Complications of subarachnoid hemorrhage

Subarachnoid hemorrhage is a relatively serious condition. Most patients suffer from this due to the rupture of an aneurysm, while others may have arteriovenous malformations. This disease is associated with complications, with common ones including the following. First, there are acute complications of subarachnoid hemorrhage. Patients usually experience severe pain and vomiting again after their condition stabilizes, and the mortality rate significantly increases. The second complication is cerebral vasospasm, which typically peaks between three days and two weeks. Cerebral vasospasm can easily lead to vascular occlusion and the subsequent formation of cerebral thrombosis. The third type includes acute or subacute hydrocephalus. Additionally, seizures and electrolyte disorders may also occur as complications.

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Subarachnoid hemorrhage clinical manifestations

When a subarachnoid hemorrhage occurs, patients can experience varying degrees of headache, usually unbearable, accompanied by nausea and vomiting. Projectile vomiting indicates high intracranial pressure in the patient. Hours after the second subarachnoid hemorrhage, signs of meningeal irritation can appear, generally presenting positively, such as neck stiffness, headache, vomiting, etc. The third issue involves varying degrees of consciousness and mental disorders in patients, and some may even display symptoms of epilepsy. Therefore, with the appearance of the above clinical symptoms, patients should actively seek treatment from a neurologist for further management.

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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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How long is the recovery period for subarachnoid hemorrhage?

The recovery period for subarachnoid hemorrhage is four to six weeks, during which absolute bed rest is theoretically required. Subarachnoid hemorrhage is a severe emergency in internal medicine with a very high mortality rate. Common causes of subarachnoid hemorrhage include cerebral vascular malformation, cerebral aneurysm, and rupture of blood vessels into the subarachnoid space, causing various symptoms. The main symptoms include severe headache, increased intracranial pressure, nausea, and vomiting. There are three layers of meninges in the subarachnoid space, consisting of the pia mater, arachnoid mater, and dura mater. Between the pia mater and the arachnoid mater is the subarachnoid space. Following a subarachnoid hemorrhage, a large amount of blood enters the subarachnoid space, leading to increased intracranial pressure, which can cause cerebral edema, brain cell death, and even brain herniation, potentially compressing the respiratory control center and leading to death. Without proper treatment, the mortality rate of a second subarachnoid hemorrhage can reach up to 50%, and for a third subarachnoid hemorrhage, survival is almost impossible with the mortality rate nearly 100%.

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Subarachnoid hemorrhage nausea and vomiting how to treat

Patients with subarachnoid hemorrhage experiencing nausea and vomiting can still be treated. Firstly, symptomatic treatment should be conducted, which can include using gastric mucosal protectants and antiemetic medications to effectively alleviate symptoms. Additionally, subarachnoid hemorrhage, nausea, and vomiting are often caused by increased intracranial pressure. In such cases, using mannitol or furosemide to dehydrate can reduce intracranial pressure. Once the intracranial pressure decreases, the symptoms of nausea and vomiting can be greatly improved and alleviated. Of course, some patients may also have complications such as hydrocephalus or intracerebral hematoma. In these cases, surgical interventions like craniotomy for hematoma removal or aneurysm clipping may be necessary, which can gradually relieve and improve the symptoms of nausea and vomiting. Beyond symptomatic treatment, it is also necessary to treat the underlying primary disease, addressing causes such as aneurysms or vascular malformations.