Subarachnoid Hemorrhage CT Imaging Manifestations

Written by Shen Jiang Chao
Radiology
Updated on February 20, 2025
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Subarachnoid hemorrhage is caused by the rupture of cerebral blood vessels due to various reasons, allowing blood to flow into the subarachnoid space. Common causes include trauma and rupture of congenital aneurysms. Subarachnoid hemorrhage caused by the rupture of congenital aneurysms typically presents on a CT scan with high-density appearances at the base of the skull in the brain pools, especially widespread columnar high-density appearances in the suprasellar cistern, lateral fissure cistern, anterior interhemispheric fissure, and around the circumferential pool. If the subarachnoid hemorrhage is due to trauma, the abnormalities are more localized, generally appearing in the brain pool or cerebral sulcus on the side of injury with high-density appearances, and may also be accompanied by hematomas within the ventricles or bleeding in other locations.

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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 Shen Jiang Chao
Radiology
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subarachnoid hemorrhage CT manifestations

Subarachnoid hemorrhage often occurs spontaneously and due to trauma. Spontaneous subarachnoid hemorrhages are usually caused by the rupture of an aneurysm. They have relatively obvious manifestations on CT, appearing as increased columnar strip densities in areas like the suprasellar cistern, quadrigeminal cistern, cerebellar tent, falx cerebri, and lateral fissure pools, as well as strip-like high density shadows within the cerebral sulci and gyri. If the subarachnoid hemorrhage is traumatic, the CT manifestations are generally mild, potentially only showing local fuzziness of the cerebral septum. At the same time, there may also be brain contusion-laceration injuries, such as extradural hematoma, subdural hematoma, and skull fractures.

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Written by Wei Shi Liang
Intensive Care Unit
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Symptoms and signs of subarachnoid hemorrhage

The typical symptoms of subarachnoid hemorrhage include headache, vomiting, and sudden severe pain, accompanied by vomiting, pale complexion, and whole-body cold sweats. Additionally, there may be disturbances in consciousness and psychiatric symptoms. Most patients do not experience disturbances in consciousness, but may exhibit restlessness and agitation. Severe cases can show varying degrees of clouded consciousness, and even coma, with a few instances displaying seizures and psychiatric symptoms. Furthermore, signs of meningeal irritation are also present, particularly common and pronounced in young and middle-aged patients, characterized by neck stiffness, headaches, and vomiting.

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Written by Liu Yan Hao
Neurology
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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.)

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Written by Wang Li Bing
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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.