Subarachnoid Hemorrhage CT Imaging Manifestations

Written by Shen Jiang Chao
Radiology
Updated on February 20, 2025
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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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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.

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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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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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Postoperative care for subarachnoid hemorrhage

For patients recovering from subarachnoid hemorrhage, a critical aspect of care is to prevent emotional excitement and avoid any exertion initiated by the patients themselves. This includes avoiding forceful movements such as turning over or straining during bowel movements, which are not permitted. Patients must rest in bed absolutely, for four to six weeks. Therefore, during nursing, it is important to assist patients with passive movements, such as turning them over every two hours to gently pat their backs. The purpose of patting the back is to effectively prevent the occurrence of dependent pneumonia, while turning them helps prevent pressure sores. Additionally, assistance can be provided for passive limb movements and massaging the limbs, which can effectively prevent the formation of venous thrombosis in the lower or upper limbs. These are the focal points of nursing that can significantly promote the patient's recovery from their condition.

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Subarachnoid hemorrhage MR manifestations

Subarachnoid hemorrhage is typically visible on an MR scan, where blood presence can be detected in the cerebral sulci. MR stands for Magnetic Resonance, and it offers various scanning sequences such as T1, T2, diffusion imaging, and fluid-attenuated inversion recovery (FLAIR). Although it may sound complex, these sequences can show high signals in areas of the brain sulci where normally there should be no distinctive signals or colors. After a subarachnoid hemorrhage, these areas show up as brightly lit on the images. Hence, magnetic resonance imaging is particularly sensitive to even small amounts of subarachnoid hemorrhage, especially noticeable in the diffusion imaging sequences where these bright signals are prominently visible.