Complications of subarachnoid hemorrhage

Written by Zhang Hui
Neurology
Updated on September 27, 2024
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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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Written by Zhang Hui
Neurology
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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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Written by Zhang Hui
Neurology
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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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Written by Wei Shi Liang
Intensive Care Unit
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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.

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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 Wang Li Bing
Intensive Care Medicine Department
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Subarachnoid hemorrhage headache causes

Subarachnoid hemorrhage commonly presents with clinical symptoms such as headache, reflex vomiting, and even consciousness disorders, seizures, etc. The main reasons for headaches caused by subarachnoid hemorrhage are, firstly, increased intracranial pressure, and secondly, impaired absorption of cerebrospinal fluid, leading to excessive accumulation in the subarachnoid space causing headaches. Additionally, blood entering the subarachnoid space can stimulate the meninges and toxic substances can also cause headaches. Therefore, patients should go to the hospital for a complete cranial CT examination and consult with the Department of Neurology or Neurosurgery.