Subarachnoid hemorrhage nursing rounds

Written by Zhang Hui
Neurology
Updated on September 12, 2024
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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 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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Written by Zhang Hui
Neurology
1min 11sec home-news-image

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.

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Written by Zhang Jin Chao
Neurosurgery
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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 a condition.

Subarachnoid hemorrhage refers to the rupture of blood vessels due to lesions at the base or on the surface of the brain, with blood directly flowing into the subarachnoid space, causing a clinical syndrome. This is different from cerebral hemorrhage, which refers to bleeding within the brain tissue itself, not into the subarachnoid space. So, what is the subarachnoid space? The human brain is covered by three layers of membranes: the pia mater, arachnoid, and dura mater. The subarachnoid space is the area between the pia mater and the arachnoid membrane, named as such. When there is a rupture in cerebral vascular malformations or cerebral aneurysms, blood flows directly into the subarachnoid space rather than causing bleeding in the brain tissue. Subarachnoid hemorrhage is considered a very serious medical condition with a very high mortality rate. Its main symptoms include severe headache, increased intracranial pressure, nausea, and projectile vomiting. If it is a second occurrence of subarachnoid hemorrhage, the mortality rate can reach up to 50%. A third occurrence of subarachnoid hemorrhage almost certainly results in death.

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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.