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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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 Zhang Jin Chao
Neurosurgery
46sec home-news-image

Is it normal to have a fever with subarachnoid hemorrhage?

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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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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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 Liu Yan Hao
Neurology
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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.