What to do with a headache from subarachnoid hemorrhage?

Written by Li Ai Ping
Neurology
Updated on October 27, 2024
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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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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.

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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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Clinical manifestations of subarachnoid hemorrhage

The clinical manifestations of subarachnoid hemorrhage include severe headache, projectile vomiting, and neck stiffness, sometimes accompanied by disturbances in consciousness. Some describe the headache caused by subarachnoid hemorrhage as the most severe headache of their lives. This severe pain is due to the congestion stimulating the meninges, causing pain that is typically very severe. Because the bleeding into the subarachnoid space allows blood to enter between the pia mater and the arachnoid membrane, stimulating the meninges and leading to these severe headaches, it causes a rapid increase in intracranial pressure and projectile vomiting. Patients may exhibit disturbances in consciousness and symptoms of irritability. This condition is considered a severe medical emergency that requires hospitalization for comprehensive treatment, with strict bed rest for four to six weeks, and it has a very high mortality rate.

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Subarachnoid hemorrhage examination methods

Subarachnoid hemorrhage is also relatively common in clinical practice. Patients may experience severe headaches, nausea, and projectile vomiting. The clinical signs generally include positive meningeal irritation signs, typically presenting with neck stiffness, Kernig's sign, and Brudzinski's sign all being positive. Clinically, the diagnosis can be confirmed mainly through cranial CT scans. If conditions permit, lumbar puncture can be performed to ascertain the nature of the cerebrospinal fluid and the intracranial pressure, etc. After a subarachnoid hemorrhage occurs, patients should be admitted to the neurology department for active treatment, and typically receive dehydration therapy to reduce intracranial pressure and neuroprotection among other symptomatic treatments.

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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.)