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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Written by Wang Li Bing
Intensive Care Medicine Department
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Pre-symptoms of subarachnoid hemorrhage

Before a subarachnoid hemorrhage, patients generally do not exhibit obvious symptoms. However, if a patient suddenly experiences severe headaches, nausea, vomiting, and other discomforts, subarachnoid hemorrhage should be suspected. The patient should promptly seek attention and complete a cranial CT scan. If the diagnosis of subarachnoid hemorrhage is confirmed, measures should be taken to dehydrate the patient and reduce intracranial pressure. If the patient has a significant amount of intracranial bleeding, surgical treatment should be considered to remove intracranial hematomas and other proactive managements, while dynamically observing changes in the patient's consciousness and pupils.

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Written by Liu Yan Hao
Neurology
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Subarachnoid hemorrhage is caused by what?

The most common cause of subarachnoid hemorrhage is the rupture of a cerebral aneurysm. The subarachnoid space is located on the surface of the brain, surrounded by three layers of meninges: from inner to outer, they are the pia mater, arachnoid mater, and dura mater. The space between the pia mater and arachnoid mater is known as the subarachnoid space. Following the rupture of a cerebral aneurysm, blood enters this subarachnoid space, leading to hemorrhage. Subarachnoid hemorrhage is a critical condition in internal medicine, with a relatively high mortality rate. The most common cause is a cerebral aneurysm, and patients who have suffered a subarachnoid hemorrhage should undergo brain MRI and vascular imaging to check for the presence of cerebral aneurysms or vascular abnormalities. If a cerebral aneurysm is present, it needs to be treated promptly. Typical interventions include placing a coiling spring to close off the aneurysm, preventing it from rupturing and thus averting a secondary subarachnoid hemorrhage, which has a mortality rate as high as 50%. Another common cause of subarachnoid hemorrhage is brain trauma, which is also a frequent cause of this condition.

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Written by Liu Yan Hao
Neurology
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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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Written by Zhang Hui
Neurology
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Subarachnoid hemorrhage: how to treat?

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 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.