Subarachnoid hemorrhage clinical manifestations

Written by Liu Yan Hao
Neurology
Updated on January 23, 2025
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Patients with subarachnoid hemorrhage typically exhibit persistent, severe headaches accompanied by projectile vomiting. Patients often experience symptoms of clouded consciousness, irritability, and anxiety. The most common cause of subarachnoid hemorrhage is the rupture of cerebral aneurysms, with blood entering the subarachnoid space, stimulating the pia mater and arachnoid membrane, and inducing severe headaches. This also leads to a rapid increase in intracranial pressure, causing projectile vomiting. Additionally, symptoms often include clouded consciousness and restlessness. Treatment requires complete bed rest for four to six weeks, using hemostatic, analgesic, and sedative medications to allow the patient to rest quietly. (Use specific medications only under the guidance of a doctor, and do not self-medicate.)

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Written by Wang Li Bing
Intensive Care Medicine Department
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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.

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Written by Zhang Jin Chao
Neurosurgery
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Subarachnoid hemorrhage causes increased intracranial pressure.

Patients with subarachnoid hemorrhage often have very high intracranial pressure. The main reason for the rise in intracranial pressure is that after the hemorrhage, the bloody cerebrospinal fluid usually stimulates nerves and blood vessels within the brain, which can lead to edema, such as vascular edema and neural edema, thereby gradually increasing the intracranial pressure. Sometimes, and relatively infrequently, the increase in cranial pressure is not significant. However, if the volume of subarachnoid hemorrhage is very large, the intracranial pressure can rise substantially, leading to symptoms like severe nausea, vomiting, and headache, and in severe cases, there can be significant disturbances in consciousness. Additionally, patients with subarachnoid hemorrhage may sometimes experience obstructive or communicating hydrocephalus, which can also lead to increased cranial pressure.

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Written by Wei Shi Liang
Intensive Care Unit
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Symptoms and signs of subarachnoid hemorrhage

The typical symptoms of subarachnoid hemorrhage include headache, vomiting, and sudden severe pain, accompanied by vomiting, pale complexion, and whole-body cold sweats. Additionally, there may be disturbances in consciousness and psychiatric symptoms. Most patients do not experience disturbances in consciousness, but may exhibit restlessness and agitation. Severe cases can show varying degrees of clouded consciousness, and even coma, with a few instances displaying seizures and psychiatric symptoms. Furthermore, signs of meningeal irritation are also present, particularly common and pronounced in young and middle-aged patients, characterized by neck stiffness, headaches, and vomiting.

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Written by Shen Jiang Chao
Radiology
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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 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.