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Subarachnoid hemorrhage
Differentiation between subarachnoid hemorrhage and cerebral hemorrhage
Subarachnoid hemorrhage and cerebral hemorrhage, though both involve bleeding, have different mechanisms of onset. The first distinction is that cerebral hemorrhage is generally caused by hypertension. Hypertension leads to hyaline degeneration and fibrinoid necrosis of arteries, resulting in bleeding. In contrast, the most common cause of subarachnoid hemorrhage is an aneurysm, which may be related to factors such as smoking and congenital developmental abnormalities. In terms of clinical presentation, cerebral hemorrhage has a sudden onset, with symptoms of headache, nausea, vomiting, but also includes impairments in language functions, and signs of neurological deficits such as limb paralysis. Subarachnoid hemorrhage, on the other hand, typically involves very severe pain, usually without manifestations such as limb paralysis. Furthermore, from a radiological perspective on CT imaging, cerebral hemorrhage is mainly located in the brain parenchyma, while subarachnoid hemorrhage mainly indicates that the site of bleeding is in the subarachnoid space.
Clinical manifestations of subarachnoid hemorrhage
The main clinical manifestations of subarachnoid hemorrhage are sudden severe headache, accompanied by nausea and vomiting, with positive signs of meningeal irritation. If such symptoms occur, it is urgent to seek medical attention and perform a cranial CT scan. If the CT shows a high-density shadow in the subarachnoid space, it can be diagnosed as subarachnoid hemorrhage, and the patient should be treated in neurology or neurosurgery for active management. Clinically, conservative medication treatment is generally adopted, paying attention to changes in the patient's consciousness and pupils, and surgical treatment may be considered if necessary.
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.
What to pay attention to during the recovery period of subarachnoid hemorrhage?
Patients with subarachnoid hemorrhage generally have aneurysms or arteriovenous malformations as the cause. After onset, the main symptom is usually headache, with positive meningeal irritation signs found during examination, but no signs of neurological function deficit. Therefore, during the recovery phase, patients generally do not show positive neurological signs and have good limb mobility. It is only necessary to take precautions against the cause of the disease. For instance, if the patient's cerebral aneurysm has not been surgically treated, there could be a risk of rebleeding. Patients should minimize physical activity, rest in bed as much as possible, and avoid aneurysm rupture. Regular blood pressure control is also essential. If the cause has already been addressed, there are not many precautions needed. Additionally, long-term administration of nimodipine is necessary to prevent delayed cerebral vasospasm, generally recommended for a period of four to six months. (Medication should be used under the guidance of a doctor based on specific conditions.)
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.
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.
Does subarachnoid hemorrhage require surgery?
Subarachnoid hemorrhage is a rather dangerous disease with very high mortality and disability rates. It mainly manifests as sudden severe headaches, nausea, and vomiting, and complications such as bleeding, cerebral vasospasm, and electrolyte disorders can occur. The most common cause of subarachnoid hemorrhage is due to the rupture of an aneurysm. Therefore, it is generally advocated that patients with subarachnoid hemorrhage undergo surgery as soon as possible. The surgical method mainly involves local anesthesia, and a complete cerebral angiography is performed to check for the presence of an aneurysm. If an aneurysm is present, an interventional embolization can be performed, which causes less trauma and generally has a better prognosis. If there is a large amount of bleeding and the patient's life is in danger, a craniotomy may also be necessary. Thus, patients with subarachnoid hemorrhage need to undergo surgical treatment.
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.
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.
How is subarachnoid hemorrhage treated?
The treatment of subarachnoid hemorrhage primarily aims to prevent rebleeding, vasospasm, hydrocephalus, and other complications, reducing mortality and disability rates. During the acute phase, keep the patient's head in a raised position, lying on their side, and provide dehydration, sedation, and pain relief; absolute bed rest; monitor blood pressure; and when bleeding is significant, undertake ventricular puncture for drainage. Patients with subarachnoid hemorrhage should generally be admitted to the ICU, monitoring vital signs and changes in neurological signs, ensuring airway patency, maintaining stable respiratory and circulatory functions, resting quietly, avoiding emotional agitation, ensuring smooth bowel movements, and for patients with increased intracranial pressure, appropriately restricting fluid intake.