Postoperative care for subarachnoid hemorrhage

Written by Liu Yan Hao
Neurology
Updated on November 01, 2024
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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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Written by Tang Li Li
Neurology
1min 17sec home-news-image

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

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 Liu Yan Hao
Neurology
1min 18sec home-news-image

Subarachnoid hemorrhage is caused by what?

The most common cause of subarachnoid hemorrhage is the rupture of a cerebral aneurysm. The subarachnoid space is located on the surface of the brain, surrounded by three layers of meninges: from inner to outer, they are the pia mater, arachnoid mater, and dura mater. The space between the pia mater and arachnoid mater is known as the subarachnoid space. Following the rupture of a cerebral aneurysm, blood enters this subarachnoid space, leading to hemorrhage. Subarachnoid hemorrhage is a critical condition in internal medicine, with a relatively high mortality rate. The most common cause is a cerebral aneurysm, and patients who have suffered a subarachnoid hemorrhage should undergo brain MRI and vascular imaging to check for the presence of cerebral aneurysms or vascular abnormalities. If a cerebral aneurysm is present, it needs to be treated promptly. Typical interventions include placing a coiling spring to close off the aneurysm, preventing it from rupturing and thus averting a secondary subarachnoid hemorrhage, which has a mortality rate as high as 50%. Another common cause of subarachnoid hemorrhage is brain trauma, which is also a frequent cause of this condition.

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Written by Tang Bo
Neurology
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Is subarachnoid hemorrhage considered a minor injury?

Subarachnoid hemorrhage depends on the amount of bleeding and the location to determine the severity of the condition. It can be life-threatening in severe cases. If symptoms such as headache and severe vomiting occur, the possibility of subarachnoid hemorrhage should be considered. Initially, a cranial CT scan should be conducted to confirm the diagnosis. Further investigations should include cranial MRI or CTA vascular imaging, preferably CTA, to determine whether there is rupture bleeding caused by an aneurysm. In such cases, it is necessary to consider whether emergency surgery is required, based on the amount of bleeding and the condition of the blood vessels, and the possibility of an aneurysm to guide further treatment.

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Written by Zhang Hui
Neurology
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Complications of subarachnoid hemorrhage

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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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.