What to pay attention to during the recovery period of subarachnoid hemorrhage?

Written by Tang Li Li
Neurology
Updated on September 10, 2024
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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.)

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Written by Zhang Hui
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Causes of subarachnoid hemorrhage

Subarachnoid hemorrhage is a very dangerous disease, in which patients experience severe headaches, noticeable nausea, vomiting, restlessness, and agitation. If the bleeding is extensive, the patient can quickly become comatose and may develop serious complications such as cerebral vasospasm and hydrocephalus. Common causes of cerebral hemorrhage include: First, cerebral aneurysms. Cerebral aneurysms are the most common cause of subarachnoid hemorrhage and may be related to congenital developmental abnormalities or acquired factors such as smoking. Second, arteriovenous malformations, which are also a common cause of bleeding. Third, there are other causes, such as trauma or coagulation disorders, and long-term use of anticoagulant medications may also be contributing factors.

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Written by Liu Yan Hao
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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.

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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
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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.

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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.