Is there a cure for secondary bleeding in subarachnoid hemorrhage?

Written by Zhang Jin Chao
Neurosurgery
Updated on January 26, 2025
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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.

Other Voices

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Written by Zhang Hui
Neurology
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Does subarachnoid hemorrhage have a genetic component?

Subarachnoid hemorrhage, this disease does not have a significant genetic tendency, so there is no need to worry excessively. The main cause of the bleeding is the rupture of an aneurysm, which is due to abnormal blood vessel development resulting in fusiform aneurysms that rupture and bleed under certain conditions. Additionally, there are other causes of subarachnoid hemorrhage, such as long-term smoking which can cause arterial disease, some arteriovenous malformations are also prone to rupture and bleed, and some traumatic injuries can also lead to subarachnoid hemorrhage; these are not hereditary. Subarachnoid hemorrhage is a rather dangerous condition, so it is essential to control risk factors, properly manage blood pressure, and absolutely avoid smoking. If severe headaches, nausea, and vomiting occur, it is crucial to be highly vigilant and seek medical attention at a hospital immediately.

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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 Wang Li Bing
Intensive Care Medicine Department
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Clinical manifestations of subarachnoid hemorrhage

The main clinical manifestations of subarachnoid hemorrhage are sudden severe headache, accompanied by nausea and vomiting, with positive signs of meningeal irritation. If such symptoms occur, it is urgent to seek medical attention and perform a cranial CT scan. If the CT shows a high-density shadow in the subarachnoid space, it can be diagnosed as subarachnoid hemorrhage, and the patient should be treated in neurology or neurosurgery for active management. Clinically, conservative medication treatment is generally adopted, paying attention to changes in the patient's consciousness and pupils, and surgical treatment may be considered if necessary.

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Written by Li Hu Chen
Imaging Center
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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.

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Written by Zhang Hui
Neurology
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Complications of subarachnoid hemorrhage

Subarachnoid hemorrhage is a relatively serious condition. Most patients suffer from this due to the rupture of an aneurysm, while others may have arteriovenous malformations. This disease is associated with complications, with common ones including the following. First, there are acute complications of subarachnoid hemorrhage. Patients usually experience severe pain and vomiting again after their condition stabilizes, and the mortality rate significantly increases. The second complication is cerebral vasospasm, which typically peaks between three days and two weeks. Cerebral vasospasm can easily lead to vascular occlusion and the subsequent formation of cerebral thrombosis. The third type includes acute or subacute hydrocephalus. Additionally, seizures and electrolyte disorders may also occur as complications.