Is it normal to have a fever with subarachnoid hemorrhage?

Written by Zhang Jin Chao
Neurosurgery
Updated on February 12, 2025
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It is normal for patients with subarachnoid hemorrhage to develop a fever, but this must be assessed in conjunction with the patient’s body temperature and overall condition.

Sometimes, the amount of bleeding in the subarachnoid space is small and may cause mild fever, mainly due to the irritation of the nerves by bloody cerebrospinal fluid. In other cases, when there is a lot of bleeding, it may cause high fever, possibly central fever, which requires specific measures to reduce the body temperature, such as pharmacotherapy, applying ice packs, or using hypothermia therapy devices.

Additionally, some patients develop a fever three to five days after the subarachnoid hemorrhage, which might indicate a secondary infection, such as lung or urinary tract infections, necessitating anti-infection treatment.

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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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Is subarachnoid hemorrhage hereditary?

Subarachnoid hemorrhage occurs due to the rupture of intracranial blood vessels and the subsequent leaking of blood into the subarachnoid space. In most cases, this condition is caused by the rupture of an aneurysm. This disease does not have a significant genetic predisposition, so there is no need for excessive worry. The common causes of this disease are primarily intracranial aneurysms, followed by vascular malformations. It should be noted that arteriosclerosis can also lead to the formation of aneurysms, and long-term smoking can also cause aneurysms. Subarachnoid hemorrhage often begins abruptly, and the patient might be engaged in some physical activity or experiencing fluctuating emotions when suddenly severe headache, nausea, vomiting, and even consciousness disturbances occur. It is essential to treat a subarachnoid hemorrhage as soon as possible.

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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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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 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.