Clinical manifestations of subarachnoid hemorrhage

Written by Wang Li Bing
Intensive Care Medicine Department
Updated on September 14, 2024
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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.

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Written by Zhang Jin Chao
Neurosurgery
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Is there a cure for secondary bleeding in subarachnoid hemorrhage?

This needs to be specifically analyzed based on the patient's condition. In most cases, a second subarachnoid hemorrhage is often very severe and generally considered beyond recovery. The patient is likely to die or, even if their life is saved, they may suffer from serious sequelae. They may remain in a prolonged coma, exist in a vegetative state, or suffer from severe impairments that prevent them from caring for themselves. However, some patients are luckier. With a second or third subarachnoid hemorrhage that is not very severe, if it is recognized early and treated promptly, and if the primary diseases are managed and aneurysms are treated with embolization or craniotomy for clipping, the outcomes can be favorable. In such cases, complete recovery is possible, and the patient can be saved.

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Written by Tang Bo
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Is subarachnoid hemorrhage considered a minor injury?

Subarachnoid hemorrhage depends on the amount of bleeding and the location to determine the severity of the condition. It can be life-threatening in severe cases. If symptoms such as headache and severe vomiting occur, the possibility of subarachnoid hemorrhage should be considered. Initially, a cranial CT scan should be conducted to confirm the diagnosis. Further investigations should include cranial MRI or CTA vascular imaging, preferably CTA, to determine whether there is rupture bleeding caused by an aneurysm. In such cases, it is necessary to consider whether emergency surgery is required, based on the amount of bleeding and the condition of the blood vessels, and the possibility of an aneurysm to guide further treatment.

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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.

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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.

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Nursing Measures for Subarachnoid Hemorrhage

Subarachnoid hemorrhage is a rather dangerous disease that develops very quickly, causing severe headaches, nausea, vomiting in patients, and this disease has a high probability of bleeding, potentially causing some cerebral vasospasm, leading to secondary thrombus formation. Besides prompt treatment and identifying the cause, such as clipping an aneurysm, nursing measures are also very important. Common nursing measures mainly include: First, it is essential to educate the patient to stay in bed and rest absolutely, as premature activity may cause the aneurysm to rupture and rebleed. Second, the patient must be instructed to maintain smooth bowel movements and a stable emotional state to prevent increased intracranial pressure and rebleeding due to emotional excitement or constipation. Third, the patient should be encouraged to drink more water and be given sufficient fluids to prevent cerebral vasospasm and low perfusion effects. Other nursing measures include stabilizing the patient's mood and providing sedation when necessary.