Is it normal to have a fever with subarachnoid hemorrhage?

Written by Zhang Jin Chao
Neurosurgery
Updated on February 12, 2025
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It is normal for patients with subarachnoid hemorrhage to develop a fever, but this must be assessed in conjunction with the patient’s body temperature and overall condition.

Sometimes, the amount of bleeding in the subarachnoid space is small and may cause mild fever, mainly due to the irritation of the nerves by bloody cerebrospinal fluid. In other cases, when there is a lot of bleeding, it may cause high fever, possibly central fever, which requires specific measures to reduce the body temperature, such as pharmacotherapy, applying ice packs, or using hypothermia therapy devices.

Additionally, some patients develop a fever three to five days after the subarachnoid hemorrhage, which might indicate a secondary infection, such as lung or urinary tract infections, necessitating anti-infection treatment.

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Complications of subarachnoid hemorrhage

Subarachnoid hemorrhage is a very dangerous disease primarily caused by the rupture of the meninges or blood vessels at the base of the skull, leading to blood entering the subarachnoid space. Clinically, the most common cause is an aneurysm, but it can also occur with some arteriovenous malformations. Subarachnoid hemorrhage can cause severe headaches, nausea, vomiting, and other complications, with severe cases leading to coma. Common complications of subarachnoid hemorrhage include, firstly, rebleeding. The probability of rebleeding is very high, and if it occurs, the disability and mortality rates of the patient significantly increase. Secondly, cerebral vasospasm, which is an important complication that can lead to severe cerebral thrombosis due to intense constriction of the blood vessels. Thirdly, it can cause secondary hyponatremia, leading to electrolyte imbalance. Additionally, complications of subarachnoid hemorrhage include increased intracranial pressure, hydrocephalus, and more.

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Subarachnoid hemorrhage MR manifestations

Subarachnoid hemorrhage is typically visible on an MR scan, where blood presence can be detected in the cerebral sulci. MR stands for Magnetic Resonance, and it offers various scanning sequences such as T1, T2, diffusion imaging, and fluid-attenuated inversion recovery (FLAIR). Although it may sound complex, these sequences can show high signals in areas of the brain sulci where normally there should be no distinctive signals or colors. After a subarachnoid hemorrhage, these areas show up as brightly lit on the images. Hence, magnetic resonance imaging is particularly sensitive to even small amounts of subarachnoid hemorrhage, especially noticeable in the diffusion imaging sequences where these bright signals are prominently visible.

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Symptoms of subarachnoid hemorrhage

Subarachnoid hemorrhage is a rather dangerous disease, generally caused by the rupture of an aneurysm, but it can also be due to cerebral arteriovenous malformations. The symptoms of the hemorrhage mainly manifest as severe headache, with many patients describing it as the worst headache of their life. Additionally, patients may experience significant nausea and vomiting, and signs of meningeal irritation such as neck stiffness. Patients with subarachnoid hemorrhage may also develop a fever, though typically not exceeding 38 degrees Celsius, and may experience cerebral vasospasms. If the spasms are severe, they could lead to secondary cerebral thrombosis. Moreover, if the bleeding is substantial, the patient may also suffer from consciousness disorders such as coma, as well as serious complications like electrolyte imbalances and hyponatremia.

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What is good to eat for subarachnoid hemorrhage?

Subarachnoid hemorrhage is most commonly caused by an aneurysm. Once an aneurysm ruptures, it can lead to blood leaking into the subarachnoid space, causing severe headaches, nausea, vomiting, and other clinical symptoms. The onset is very sudden and the headaches can be extremely intense. It is crucial to treat aggressively and clamp the aneurysm as soon as possible. The diet for patients with subarachnoid hemorrhage should include: First, it is essential to take anti-vasospasm medications, as subarachnoid hemorrhage can easily lead to arterial spasms. Calcium channel blockers should be used to prevent arterial spasms to avoid severe complications. Second, consume foods that aid in bowel movements, such as bananas, apples, and oranges. It is vital for patients with subarachnoid hemorrhage to maintain regular bowel movements, and these foods can help. Third, eat high-quality proteins to strengthen the body and prevent complications. This can include fish, lean meats, beef, and drinking milk.

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Subarachnoid Hemorrhage CT Imaging Manifestations

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.