How to treat subarachnoid hemorrhage effectively

Patients with subarachnoid hemorrhage must pay attention to taking correct nursing and treatment measures, keep the patient's breathing unobstructed, let them rest quietly and avoid stimulation, and also pay attention to symptomatic treatment with sedatives, antitussives and anti-epileptic drugs.

1. General treatment and symptomatic treatment

Monitor changes in vital signs and neurological signs, keep the airway open, and maintain stable breathing and circulation. Lie quietly in bed, avoid excitement and exertion, keep bowel movements normal, and use sedatives, antitussives and anti-epileptic drugs symptomatically.

2. Reduce intracranial pressure

Appropriately limit fluid intake to prevent and treat hyponatremia. Dehydrating agents such as mannitol and furosemide are commonly used in clinical practice to reduce intracranial pressure, and albumin may also be used as appropriate. When accompanied by a large intracerebral hematoma, surgery can be performed to remove the hematoma to reduce intracranial pressure and save lives.

3. Prevent and treat rebleeding

(1) Rest quietly and stay in bed for 4-6 weeks; (2) Control blood pressure. The patient's blood pressure may rise due to severe pain, so pay attention to eliminating the causes such as pain. (3) Use antifibrinolytic drugs to prevent rebleeding caused by dissolution of blood clots around the aneurysm. Commonly used drugs include aminocaproic acid, aminobenzoic acid, etc. (4) Surgical removal of the aneurysm is the best way to prevent rebleeding of aneurysmal SAH.

Prevent and treat cerebral vasospasm

(2) Maintain blood volume and blood pressure. If necessary, administer colloid fluid to expand blood volume and intravenous dopamine. 3H therapy (hypervolemia, increased blood pressure, and hemodilution) is widely used abroad to treat cerebral vasospasm after SAH. (2) Early use of calcium channel blockers such as nimodipine. (3) Early surgery to remove aneurysms and blood clots.

Preventing and treating hydrocephalus

(3) Give acetazolamide to inhibit cerebrospinal fluid secretion, or use dehydration drugs such as mannitol and furosemide. (2) When medical treatment is ineffective, cerebrospinal fluid shunt surgery can be performed: ventriculo-atrial or ventriculoperitoneal shunt to avoid aggravating brain damage.