How long is the recovery period for subarachnoid hemorrhage?

Written by Liu Yan Hao
Neurology
Updated on April 25, 2025
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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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Written by Zhang Jin Chao
Neurosurgery
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Subarachnoid hemorrhage causes increased intracranial pressure.

Patients with subarachnoid hemorrhage often have very high intracranial pressure. The main reason for the rise in intracranial pressure is that after the hemorrhage, the bloody cerebrospinal fluid usually stimulates nerves and blood vessels within the brain, which can lead to edema, such as vascular edema and neural edema, thereby gradually increasing the intracranial pressure. Sometimes, and relatively infrequently, the increase in cranial pressure is not significant. However, if the volume of subarachnoid hemorrhage is very large, the intracranial pressure can rise substantially, leading to symptoms like severe nausea, vomiting, and headache, and in severe cases, there can be significant disturbances in consciousness. Additionally, patients with subarachnoid hemorrhage may sometimes experience obstructive or communicating hydrocephalus, which can also lead to increased cranial pressure.

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Written by Wang Li Bing
Intensive Care Medicine Department
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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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Written by Wang Li Bing
Intensive Care Medicine Department
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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.

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Written by Zhang Hui
Neurology
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Subarachnoid hemorrhage nursing rounds

Subarachnoid hemorrhage is a rather dangerous disease. Patients may experience significant symptoms such as headache, nausea, vomiting, and irritability. There can also be complications related to the nervous system. Besides medical and surgical treatment, nursing care is equally crucial. Key aspects to focus on during nursing rounds include: First, fully assess the patient's consciousness to see if they are alert or have slipped into a coma; second, observe the pupils to check if they are symmetrical and how they react to light; third, examine if there is any noticeable stiffness in the neck or signs of meningeal irritation; additionally, look at the pathological reflexes of the lower limbs; also, observe if the patient's mood is notably irritable; finally, monitor if the patient exhibits complications such as fever, cough, or expectoration, and provide the corresponding treatment.

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Written by Wei Shi Liang
Intensive Care Unit
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How is subarachnoid hemorrhage treated?

The treatment of subarachnoid hemorrhage primarily aims to prevent rebleeding, vasospasm, hydrocephalus, and other complications, reducing mortality and disability rates. During the acute phase, keep the patient's head in a raised position, lying on their side, and provide dehydration, sedation, and pain relief; absolute bed rest; monitor blood pressure; and when bleeding is significant, undertake ventricular puncture for drainage. Patients with subarachnoid hemorrhage should generally be admitted to the ICU, monitoring vital signs and changes in neurological signs, ensuring airway patency, maintaining stable respiratory and circulatory functions, resting quietly, avoiding emotional agitation, ensuring smooth bowel movements, and for patients with increased intracranial pressure, appropriately restricting fluid intake.