We are all familiar with brain hemorrhage, but when it comes to subarachnoid hemorrhage, we may have heard of it somewhere before, but we are not familiar with it. In fact, this disease is not uncommon, especially among young and middle-aged people. So, what is "subarachnoid hemorrhage"? Dr. Zhang is here today to give you an introduction to its related knowledge.

1、Subarachnoid hemorrhage in the end is a what?

Subarachnoid hemorrhage refers to a clinical syndrome caused by the rupture of blood vessels at the base of the brain or on the surface of the brain that bleed into the subarachnoid space.

2、What exactly are the symptoms of subarachnoid hemorrhage?

For subarachnoid hemorrhage there are no symptoms, it depends on the specific case. In the case of those with milder subarachnoid hemorrhages, some people don't even have any clinical signs. For those with more severe cases, the symptoms can be more severe and can even lead to coma or death. Specific symptoms can include severe headache, vomiting, signs of meningeal irritation (nuchal rigidity), and even loss of consciousness after emotional and exertional activities.

3、Who is commonly affected by subarachnoid hemorrhage?

Generally, subarachnoid hemorrhage is common in young and middle-aged people, especially young and middle-aged men. And it is common in winter and spring. It is especially common in young and middle-aged people who have poor lifestyle habits.

4、What factors lead to subarachnoid hemorrhage?

When it comes to the specific causes of subarachnoid hemorrhage, it should be said that aneurysm of the brain is its most common causative factor. As most people age, atherosclerosis gradually occurs and develops, and chronic metabolic diseases such as high blood pressure appear, and the walls of the arterial vessels become less elastic. If the blood pressure rises abnormally, the diseased arterial aneurysm can rupture, and cerebral hemorrhage occurs.

5. How is treatment provided?

For patients who are suspected of having a subarachnoid hemorrhage, have a CT of the head examined as soon as possible.

Once the subarachnoid hemorrhage is detected, contact the neurosurgery department for hospitalization in the first instance, and under the guidance of a neurosurgeon specializing in neurosurgery, a decision will be made as to whether the condition should be treated conservatively with medication or surgically, depending on the severity of the condition.

Finally, it is important to remind hypertensive patients that to reduce the incidence of cerebral hemorrhage, they must control their blood pressure and not give cerebral hemorrhage a chance to occur.

Thanks for the invitation! I'm Dr. Wei from the Department of Neurology. Subarachnoid hemorrhage (subarachnoid hemorrhage, SAH) refers to a variety of traumatic or non-traumatic intracranial hemorrhage, blood flows directly into the subarachnoid space caused by a clinical syndrome, accounting for about 10% of hemorrhagic strokes, the other type of hemorrhagic strokes is parenchymal hemorrhage (which is often referred to as cerebral hemorrhage), the two diseases are hemorrhagic, only the hemorrhagic Both are hemorrhages, only the part of the brain where the hemorrhage occurs is different.

Rupture of cerebral aneurysms is the most common cause of subarachnoid hemorrhage, accounting for about 80% of cases. An aneurysm is an abnormally dilated lesion in the wall of a blood vessel that forms a tumor-like bulge that can occur in blood vessels throughout the body, commonly in the aorta and cerebral arteries. Unless it ruptures, there are usually no obvious symptoms, and even if the aneurysm is large, the patient may not be aware that he or she has an aneurysm. Once ruptured, it can lead to internal bleeding, disability and death.

Let's take a look at the self-report of a patient with subarachnoid hemorrhage (52 years old, female) to see how it develops and how it is treated.

A year and a half ago (May 9, 2019)My alarm went off at 7:00 a.m. andI woke up with a headache., used to get similar headaches from lack of sleep, butThis time it seems a little more serious than before. I refused to take the day off and insisted on going to work because I could enjoy a few days off after this day.

8:20 in the officeI feel like the headaches are getting worse.It's like the brain is splitting open., and my head was a little unclear, my reflexes were slower, and the strength in my arms and legs was normal, but I could barely stand. I called out to my coworkers and got me to the emergency room of a nearby hospital.The doctor measured the blood pressure around 160/95mmHg, which is about the same as the usual blood pressure, and I usually have no obvious symptoms, so I didn't take any antihypertensive medication.I immediately underwent a CT scan of my brain, and after the doctor read the CT, he confirmed that I was"Subarachnoid hemorrhage.", a large area, said it was caused by a ruptured brain aneurysm.

At about 9 o'clock, the doctor recommended emergency surgery to treat theThat's when my husband and sister arrived at the hospital. They spoke with the doctor and my husband signed off on the surgery. Soon I was taken to the operating room, at which point myConsciousness is blurred, and there's no movement in the left arm or leg., vaguely felt the nurse cutting my hair, then sterilized my scalp, anesthetized it, and after an acidic sensation I knew nothing more.

After 2 days.I woke up and my sister was crying by my bedside, my husband was away from the hospital room at work, I rushed to ask her what happened and how the surgery went. I thought she was going to tell me something horrible, instead she smiled and gave me a big hug and told me everything was okay now.

But I'm filled with questions inside:

• Why is my long hair so short now, and also a large area on the right side of my head that has no hair left?
• Why are my eyes swollen?
• Why is there a pipe in my head?

The nurse came in, saw that I was awake, and immediately called the doctor. The doctor usedThe flashlight shone in my eyes, I think it was checking my pupil size and reflexes.The doctor told me I was there becauseRuptured aneurysm of the right middle cerebral artery causing subarachnoid hemorrhage involving three lobar regions of the brain, the aneurysm was surgically managed, and a catheter was placed to drain the hematoma and avoid compression of brain tissue and life-threatening high cranial pressure.

I'm shocked. IHow and why did I have a ruptured aneurysm? Is this a return from the dead?However, my left side of my arms and legs are so weak that I can't hold chopsticks to eat by myself and I can't walk on the ground.

Later, my family has been taking good care of me, feeding me, massaging me, turning me, rubbing me, etc. I am very grateful to them.

As I recall, it was about10th day of hospitalizationWhen I experienced a worsening headache and wondered if it could be re-bleeding, the doctor reviewed my cranial CT and compared it to the CT from admission, which did not show any enlargement of the bleed, and considered thecerebral vasospasm, which is common 1 to 2 weeks after a subarachnoid hemorrhage, the doctor gave me oral and intravenousNimodipine (anti-spasmodic), then my headaches subsided.

During my hospitalization, I tried to get out of bed and go to the toilet by myself, but I couldn't do it. I was very frustrated and bad-tempered, thinking that I couldn't live on my own for the rest of my life and had lost the meaning of my life, and my family had been on the sidelines constantly encouraging me to give up gently. The doctor brought in a rehabilitator to give my paralyzed limbs a makeover.Massage, Tuina, Acupuncture and Bioelectric StimulationI was able to walk slowly with a walker. Slowly and gradually I felt that I had regained some strength in my arms and legs, and the rehabber had equipped me with a walker that I could hold on to and walk slowly without falling over.

Then I switched torehabilitation hospitalContinue to do limb function rehabilitation exercise, there are speech therapy, physical therapy, psychological therapy and so on. Every day here is very fulfilling, I want to get well sooner, I work out especially hard every day.

After six months of rehabilitation, I could walk independently and eat on my own, but it was still worse than normal. It's now been a year and a half since the onset of the disease and I'm still exercising and alsoHe is very careful about what he eats and sleeps, and takes his antihypertensive medication regularly every day., keeping my blood pressure within 120/70mmHg and having my own dedicated blood pressure log book to record my daily blood pressure levels.

Doctor's Analysis:

What are the causes of brain aneurysms?

The causes of cerebral aneurysms are not well understood, but there areA range of risk factorsIt may increase the risk of developing a brain aneurysm. Brain aneurysms are more common in adults than in children, and more common in women than in men.

●middle-aged and elderly people

:: Smoking

:: Hypertension

:: Drug use, especially cocaine use

:: Alcoholism

:: Head injuries: some types of aneurysms may occur in head injuries (entrapment aneurysms)

● Infection: certain bloodstream infections that form infected aneurysms.

● Congenital anomalies of arterial wall binding.

What are the main causes of ruptured cerebral aneurysms?

:: Hypertension: high blood pressure is the leading cause of subarachnoid hemorrhage. Excessive blood pressure increases the impact on the aneurysm and promotes rupture.

:: Strong mood swings: e.g. extreme anger and sadness, increased blood pressure, ruptured aneurysm.

:: Increased cranial pressure:Head bobbing, bending hard, rising sharply, straining to defecate, and lifting heavy objects can instantly increase intracranial pressure, which can lead to aneurysm rupture

Cerebral aneurysm treatment?

Treatment of aneurysms varies by location and size。The main treatment is surgical, for aneurysm resection, arterial reconstruction, endoluminal repair of aneurysms and aneurysm embolization。

How can I prevent a ruptured aneurysm?

Generally <5mm的脑动脉瘤不易破裂；如果>5mm and located in the anterior communicating artery aneurysms are most likely to rupture.

To prevent aneurysm rupture, you should usually do: "two stabilization" and "one avoidance".

● Stabilization of blood pressure: People found to have cerebral aneurysms should have their blood pressure controlled at <130/80 mmHg, and <120/70 mmHg for those within 50 years of age, but avoid blood pressure <100/60 mmHg to avoid cerebral insufficiency of cerebral perfusion triggering cerebral infarction.

:: Emotional stability: maintain a good state of mind and avoid emotional ups and downs. Do not panic and respond calmly.

● Avoid aggressive movements: avoid heavy lifting, straining to defecate, turning the head too sharply, and head and neck trauma.

Author Words:Hello, I am Dr. Wei, who is committed to popularizing medical knowledge in concise, easy-to-understand language. It's not easy to write, so if this article is helpful, please help!● Click "Follow" or "Like".If your family and friends also need this knowledge, please:: ForwardingGive it to someone who needs it.

If about cerebrovascular disease, dizziness, insomnia and other neurological diseases of the problem, you can give me a comment message, I see will be the first time to reply, your support, that is me!Recording patient stories presents the greatest motivation for everyone, thank you!！

Subarachnoid hemorrhage is a specific type of brain hemorrhage thatThis type of bleeding has a high mortality rate once it occurs, and proper treatment can effectively minimize the sequelae.Subarachnoid hemorrhage is less prevalent compared to cerebral hemorrhage. That's why many people don't know much about this particular type of brain hemorrhage.

What are the clinical symptoms of subarachnoid hemorrhage?

There are many clinical manifestations of subarachnoid hemorrhage.

• Headache: a sudden onset headache, this pain is usually very severe and has been described as a thunderclap headache. The headache usually radiates to the neck, and patients often have neck pain along with the headache.
• Nausea and vomiting: Many people will experience nausea and vomiting, which is usually projectile vomiting.
• Twitching of the limbs: some patients experience twitching, which, once present, indicates an aggravation of the disease.
• In severe cases, patients may also experience impaired consciousness, psychiatric symptoms, incontinence, and limitation of limb movement.
• A small number of patients develop only mild headache symptoms.

What are the causes of subarachnoid hemorrhage?

1. Subarachnoid hemorrhage can be traumatic in origin, and traumatic subarachnoid hemorrhage tends to heal relatively well if not combined with other injuries.
2. Most spontaneous subarachnoid hemorrhages result from ruptured intracranial aneurysms that bleed. Spontaneous subarachnoid hemorrhage is characterized by a rapid onset and high mortality, but the prognosis is relatively good.
3. There is also a specific type of spontaneous subarachnoid hemorrhage caused by rupture of peripheral veins in the brainstem, which is most commonly seen in the elderly and usually leaves no sequelae after regular treatment.

Since traumatic subarachnoid hemorrhage and subarachnoid hemorrhage caused by rupture of peripheral veins in the brainstem are not harmful to patients, this article focuses on subarachnoid hemorrhage caused by aneurysm rupture.

What is an aneurysm?

Intracranial aneurysm is an abnormal protrusion on the wall of intracranial arterial blood vessels. It usually occurs at the bifurcation of blood vessels and at the turning point of blood vessels. This location is subjected to the impact of blood flow, and over time, an aneurysm-like bulge is formed on the wall of the blood vessel. Due to the thin wall of the blood vessel at the bulge, it is prone to rupture and bleed when blood pressure fluctuates, forming a subarachnoid hemorrhage.

Aneurysms have a prevalence of 3-7% in the adult population, but not all aneurysms rupture. Unruptured aneurysms are usually asymptomatic. People usually find an aneurysm by chance during a physical examination. For unruptured aneurysms, a neurologist needs to evaluate the risk of rupture before deciding whether to treat them.

Subarachnoid hemorrhage caused by ruptured aneurysm has a very high mortality rate. Ruptured aneurysms often do not heal and will rupture and bleed repeatedly. The mortality rate of the first rupture is over 20%, and the mortality rate of the second bleed reaches over 40%, so once subarachnoid hemorrhage occurs, it must be treated promptly.

How is subarachnoid hemorrhage due to ruptured aneurysm treated?

Treatment of subarachnoid hemorrhage due to ruptured aneurysm is divided into two steps:

Step 1: Finding the aneurysm

Once subarachnoid hemorrhage occurs, the aneurysm within the skull needs to be identified as early as possible to prevent the aneurysm from rupturing and bleeding again, which can be a life-threatening situation for the patient. However, unless it is a huge intracranial aneurysm, normal aneurysms do not show up on normal head CT and head MRI.

Finding intracranial aneurysms requires special tests, which are now commonly used by doctors as DSA (a special type of vascular test), CT angiography and magnetic angiography. The test with the highest positive rate is the DSA test, which can detect more than 90% of aneurysms.

Step 2: Treat the aneurysm

When an intracranial aneurysm is detected, there are two types of treatment. One is interventional surgery, which involves the application of a number of extremely thin medical catheters and guidewires to fill the aneurysm by passing it through the artery to the aneurysm. The second type of treatment is craniotomy, in which a special metal clip is used to hold the aneurysm.

Both of these modalities can eradicate the aneurysm. Interventional surgery is less invasive and has a quicker recovery, with the disadvantage of higher medical costs. Craniotomy is much less expensive than interventional surgery, but it is more invasive and has a higher incidence of postoperative complications than interventional surgery.

The exact type of treatment that should be chosen should be determined on a patient-by-patient basis.

Does subarachnoid hemorrhage due to aneurysm heal well?

Patients with subarachnoid hemorrhage due to ruptured aneurysms generally recover well if no other complications occur, with a few patients experiencing psychiatric symptoms or personality changes.

Thank you! A subarachnoid hemorrhage is actually just a type of brain hemorrhage, except that the location of the hemorrhage is under the arachnoid membrane, which is why it is ultimately assessed as a subarachnoid hemorrhage. This can be clearly determined by a CT scan of the head. The treatment must be evaluated according to the actual situation. Some cases may be treated with internal medicine, but some may require surgical treatment.

The number of patients with subarachnoid hemorrhage is very high, basically 20% or even 30% of people with cerebral hemorrhage have subarachnoid hemorrhage.

More than 80% of the causes of subarachnoid hemorrhage can be aneurysms, that is, the presence of such abnormal lesions on the blood vessels. Of course there are other abnormalities such as arteriovenous malformations, arteriovenous fistulas, cavernous hemangiomas, and so on.

Of course, there is also a 5-6% chance that there is no abnormal lesion of a vascular nature, and there may just be some rupture of a blood vessel that heals instantly, which is mainly seen in arteriosclerosis.

If this is the case, there is no need for special treatment, internal medicine can be conservative, improve circulation and nutritional nerve treatment, many in about two weeks will be able to discharge, home does not need special treatment.

But some may also require further treatment, such as surgical intervention.

Surgical treatment in turn encompasses two major areas, the first being interventional embolization, commonly known as minimally invasive, and the second being craniotomy entrapment.

For aneurysms, the main treatment option is still based on interventional embolization, commonly known as minimally invasive treatment, the main means is to extend a wire catheter from the root of the thigh, and then operate inside the blood vessel, filling the spring coil, so that the hemodynamics of the aneurysm is altered, and ultimately to reduce the risk of rupture of the aneurysm bleeding.

Of course, the specific surgical method and the specific situation should be judged according to the actual situation. There are many kinds of aneurysms, such as blood bubble aneurysm, saccular aneurysm, snake aneurysm, systolic aneurysm, and entrapment aneurysm, etc. Therefore, it is more meaningful to improve the examination to clarify the specific situation. Therefore, it is important to improve the examination first to clarify the specific changes in the situation so that it can be more meaningful.

For some other forms of vascular malformation, such as arteriovenous fistula, cavernous hemangioma and so on also need to go to the evaluation of the condition, to take the relevant treatment, like cavernous hemangioma, some can be taken to radiation irradiation for treatment.

So in conclusion, the treatment of subarachnoid hemorrhage is a case-by-case basis, and must be judged in the context of the patient's reality, and if you can send me the films, so that there is a more precise answer.

Contact us if you have questions.

Our brain is surrounded by several membranes, one of which is the arachnoid membrane, and inside the cavity under the arachnoid membrane is some cool fluid called cerebrospinal fluid. When a blood vessel in the brain bursts and bleeds, the flow of blood into this cavity is called subarachnoid hemorrhage. It is mostly due to rupture of an aneurysm.

The hemorrhage can cause a severe headache that is so intense that it is often described by the patient as the most painful headache of his or her life. Symptoms of neck pain and stiffness of the neck are also present, a symptom known as meningeal irritation sign, which is of great diagnostic importance.

In addition to the headache, there's nausea and vomiting.

In severe cases, loss of consciousness, seizures, and convulsions can occur.

More serious cases can be fatal

This is a very serious cerebrovascular disease, so you should seek medical attention as soon as you experience these symptoms.

A subarachnoid hemorrhage is when blood flows into the subarachnoid space due to a ruptured blood vessel in the skull.

Two causes can cause subarachnoid hemorrhage. The first is a traumatic injury, such as from impact or a car accident. The second is spontaneous bleeding in the absence of external injury. Most spontaneous hemorrhages are caused by ruptured aneurysms, which have a very high fatality rate, a poor prognosis, and a high disability rate. Of course, there are other causes of subarachnoid hemorrhage, such as vascular malformations, coagulation disorders, etc., but the most common is caused by aneurysm rupture.

Most patients with spontaneous subarachnoid hemorrhage present to the doctor with a sudden, severe headache, accompanied by nausea, vomiting, seizures, and in severe cases, even impaired consciousness. Seizures can occur especially during emotional stress or when doing physical labor. If you have 2 or more cases of aneurysmal subarachnoid hemorrhage in a first-degree relative, we also recommend CT arteriography (CTA) or magnetic resonance angiography (MRA) for aneurysm screening.

If a subarachnoid hemorrhage has been diagnosed, hospitalization is definitely required and surgery is needed if necessary. For subarachnoid hemorrhage caused by ruptured aneurysm, the doctor will consider whether to treat the aneurysm with interventional therapy or embolization based on various factors such as the location of the aneurysm, the age, and the degree of severity of the aneurysm. Many patients have more than one aneurysm, and many patients with multiple aneurysms are not able to have all the aneurysms clamped or embolized by either clamping or embolization, and even if the surgery is successful, the person still has an aneurysm of his own. In the future, the main goal is to prevent them from rupturing again.

In fact, in my opinion, spontaneous subarachnoid hemorrhage is very lucky to be able to be rescued. Some patients, even if they have subarachnoid hemorrhage caused by ruptured aneurysm in the monitoring room, some of them are difficult to be rescued due to the large amount of bleeding. Therefore, when there is a continuous headache, or sudden severe headache, accompanied by projectile vomiting patients must promptly consult a doctor, so as not to delay treatment.

The authoritative interpretation of Pharmaceutical Affairs, unauthorized reproduction, plagiarism will be punished.

Subarachnoid Hemorrhage (SAH), also known as spontaneous subarachnoid hemorrhage, is a type of hemorrhagic stroke caused by a variety of etiologies. It mainly refers to the rupture of congenital aneurysms, atherosclerotic aneurysms and superficial arteriovenous malformations located at the base of the brain in the cranium, and the blood flows directly into the subarachnoid space.

[Etiology]

The common causes are congenital aneurysms, followed by arteriovenous malformations and cerebral arteriosclerotic aneurysms. The next most common causes are cerebral arteritis caused by various infections, brain tumors, blood disorders, collagen disorders and complications of anticoagulation therapy.

[Diagnostic Points]

(i) Clinical manifestations

1. Prodromal symptoms

Headache, vertigo, nausea, vomiting, irritability, low back pain, blurred vision and seizures.

2. Headache

For sudden severe headache. If the artery is ruptured, it is a popping or dull pain that is first limited and then develops into a generalized one (the limited headache at the onset of the disease is of localizing significance; anterior headache suggests that the lesion is located in the cerebellar vermis, and posterior headache suggests that it is located in the posterior cranial recess).

3. Signs of meningeal irritation

In addition to headache, there is neck and back pain, cervical rigidity, positive Kirschner's sign and Buchholz's sign, sometimes accompanied by nausea, vomiting, photophobia and so on. Neck stiffness mostly appeared 6-12h after the onset of the disease.

4. Fever

It presents with a low, moderate or high fever that lasts for 1 to 2 weeks.

5. Disorders of consciousness

There is drowsiness, haziness to varying degrees of coma.

6. Mental symptoms

Excitement, agitation, thought disorder, memory, disorientation and hallucinations.

7. Seizures

May be grand mal or limited seizures.

8. Fundus changes

Retinal hemorrhage, pre-retinal i.e. subvitreous hemorrhage, some with optic papillary edema.

9. Cranial nerve disorders

Partial or complete paralysis of the motor nerve. Others may include abducens nerve palsy, nystagmus, unilateral Horner's sign, and hemianopsia.

10. Somatic motor and sensory disorders

Such as hemiplegia, mild hemiparesis, and hemiplegic sensory deficits.

(ii) Laboratory and ancillary tests

1. Cerebrospinal fluid examination

Lumbar puncture is of decisive value for diagnosis. Cerebrospinal fluid is homogeneous and bloody. Pressure is often elevated. In prolonged hemorrhage, the red blood cells in the cerebrospinal fluid are crumpled and the protein content may be increased.

2.CT examination

Within 4 days of the onset of the disease, there is blood in the pools at the base of the brain, the longitudinal fissure of the brain and the cerebral sulcus, which shows increased density and is seen as a localized accumulation of blood in the sulcus and pools in a thicker, more severe area suggesting that it may be the exact location of the ruptured aneurysm. Contrast-enhanced CT may reveal aneurysms or arteriovenous malformations.

[First aid and treatment]

1. Keep quiet

Minimize moving and stay in bed for 3 to 4 weeks to facilitate natural hemostasis and allow adequate repair of ruptured blood vessels. Especially avoid emotional excitement and sudden exertion, do not get out of bed too soon. Give light laxatives to keep the bowels clear.

2. Hemostatic agents

6-Aminocaproic acid 10-24g, add 10% dextrose 500ml, intravenous drip, once a day, depending on the condition of the decision to stop the drug time (usually about 2 weeks, should be reduced when the application of 7 to 10 days).

Antihemifibrinolytic aromatic acid (PAMBA), 200-400 mg, add 10% dextrose 500 ml, intravenous drip, once a day, treatment time and precautions as above.

3. Symptomatic treatment

Analgesia, sedation, can be used as appropriate, such as valium, but should be careful to use drugs with respiratory depression. Sedative drugs are strictly prohibited for those with high cranial pressure and irregular breathing. For those with high cranial pressure, 20% mannitol 250ml should be injected intravenously for 6-8h.

4. Apply antihypertensive drugs if the blood pressure is too high

5. Anti-cerebral vasospasm therapy

Those who have obvious cerebral vasospasm, in order to prevent ischemic brain damage, can apply calcium antagonists, such as cardioplegia 10-30mg, 3 times a day; nimodipine 40mg, 3 times a day.

6. Surgical treatment

Those who have aneurysms by CT, MRI, DSA or routine cerebral angiography and are suitable for surgery should be operated as early as possible to prevent recurrence; those with arteriovenous malformations can be operated at a later stage after the situation is stabilized.

　　Subarachnoid hemorrhage is a collective term for the rupture of cerebral blood vessels due to various reasons, resulting in blood flowing into the subarachnoid space, and is one of the categories of cerebral hemorrhage; clinically it is divided into two categories: traumatic and non-traumatic (such as hemorrhage caused by aneurysm, hypertension, and cerebral vascular malformations, etc.). The cerebral blood vessels are compared to water pipes, water pipe rupture may be caused by external forces, may also be the problem of the water pipe itself, which leads to hemorrhage, but due to the location of the bleeding is in the skull, so it is more dangerous than the limbs of the hemorrhage, after all, the brain is the "total command center", if the total command center of the accident, then the whole system will be collapsed. This is also why it is said that subarachnoid hemorrhage is dangerous, with a very high rate of death and disability; among the many causes, intracranial aneurysms and arteriovenous malformations are more common, which is tantamount to burying a "bomb".
Subarachnoid hemorrhage starts suddenly, and the most common mode of onset is headache, vomiting, and signs of meningeal irritation within seconds or minutes (more common in young adults and adults, mainly characterized by stiff neck, headache, and vomiting).

Clinical diagnosis is based on symptoms such as headache and meningeal irritation, but also on a CT scan of the head to see if there is any evidence of high density in the subarachnoid space.

Since the prognostic outcome of subarachnoid hemorrhage is related to timely detection and management, this requires prompt medical attention at the onset of symptoms and a good differential diagnosis to avoid delays in treatment.

After the onset of subarachnoid hemorrhage, families do three things:

First, immediately call 120 to choose a specialized hospital that has the ability to save your life;

The next step is to remain sedated and avoid shaking the patient;

Finally, do not feed water and medicine before the doctor arrives to avoid choking, misinhalation, suffocation leading to aggravation of the condition or even life-threatening.

Hello, I'm a cardiovascular king pharmacist and I'm happy to answer this question for you.

What is subarachnoid hemorrhage? What should I do?

What is subarachnoid hemorrhage? What is a subarachnoid hemorrhage?

Subarachnoid hemorrhage intervention, generally speaking, will not occur again after the operation. However, in some patients, the reoccurrence of subarachnoid hemorrhage can be caused by poor living conditions, such as irregular diet, poor living habits, etc., as well as irregular postoperative medication. The reoccurrence of subarachnoid hemorrhage is often caused by another blood vessel that was involved in the intervention, and we can perform re-intervention or surgery based on the corresponding symptoms and signs, including the results of the examination, which can continue to provide patients with a better quality of life.

　　Subarachnoid hemorrhage refers to a clinical syndrome caused by rupture of diseased blood vessels at the base of the brain or on the surface of the brain and direct flow of blood into the subarachnoid space, also known as primary subarachnoid hemorrhage, which accounts for about 10% of acute strokes and is a very serious and common disease. It is also known as secondary subarachnoid hemorrhage, which is caused by hemorrhage in the ventricles of the brain parenchyma, rupture of the epidural or subdural blood vessels, and blood flowing into the subarachnoid space through the brain tissue.

　　Ruptured intracranial aneurysms and arteriovenous malformations are common causes of subarachnoid hemorrhage, and aneurysm formation may result from congenital muscular defects in the arterial wall or acquired degeneration of the internal elastic lamina or a combination of both. Either rupture of an aneurysm, rupture of a blood vessel from an arteriovenous malformation lesion, or rupture of a blood vessel from a sudden increase in blood pressure results in blood flow into the subarachnoid space of the brain, which spreads rapidly through the cerebrospinal fluid surrounding the brain and spinal cord, irritating the meninges and causing meningeal irritation signs, such as headache and cervical rigidity. Subarachnoid hemorrhage can occur at any age, and is more common in young adults. Ruptured aneurysms occur between the ages of 30 and 60 years old, and are more common in females than males, and vascular malformations are more common in adolescents.

　　Sudden severe headache and vomiting should be suspected of subarachnoid hemorrhage, and the patient should be sent to the hospital in time. Try to keep the patient in the head-high lateral position to avoid the tongue falling back and obstructing ventilation, and clean the vomit in the mouth in time to avoid accidental aspiration into the airway. Avoid long-distance transfer as much as possible, and choose the nearest qualified medical unit for treatment. The patient should be escorted by medical personnel when transferring and observe the change of condition at any time, and take necessary measures at any time. Before transportation, patients should be treated with dehydration, antihypertensive therapy, sedative and analgesic drugs, absolute bed rest, avoiding vibration during transportation, and paying attention to the change of blood pressure at any time.

Click on the bottom of the page [Learn More] to see more answers or ask the doctor a question for free!

Follow "Family Doctor Online" headline, more health Q&A easy to see~~~~