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.

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Written by Zhang Hui

Neurology

57sec

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Symptoms of subarachnoid hemorrhage

Subarachnoid hemorrhage is a rather dangerous disease, generally caused by the rupture of an aneurysm, but it can also be due to cerebral arteriovenous malformations. The symptoms of the hemorrhage mainly manifest as severe headache, with many patients describing it as the worst headache of their life. Additionally, patients may experience significant nausea and vomiting, and signs of meningeal irritation such as neck stiffness. Patients with subarachnoid hemorrhage may also develop a fever, though typically not exceeding 38 degrees Celsius, and may experience cerebral vasospasms. If the spasms are severe, they could lead to secondary cerebral thrombosis. Moreover, if the bleeding is substantial, the patient may also suffer from consciousness disorders such as coma, as well as serious complications like electrolyte imbalances and hyponatremia.

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Written by Zhang Jin Chao

Neurosurgery

57sec

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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 Zhang Jin Chao

Neurosurgery

52sec

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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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Written by Li Hu Chen

Imaging Center

49sec

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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

1min 11sec

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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.