Subarachnoid hemorrhage

I don’t know if you have ever talked about subarachnoid hemorrhage before. Today I will briefly introduce to you why this disease occurs. I hope you can understand more after reading this article. In the future life, when faced with such situations, you will be able to cope with them with ease and remain calm.

Experts have conducted special research, which shows that smoking and drinking are closely related to subarachnoid hemorrhage. Among them, smoking can increase blood pressure, cause the fragility of cerebral blood vessels to increase, and increase the risk of blood vessel rupture and bleeding. Drinking a lot of alcohol can also increase blood pressure and accelerate subarachnoid hemorrhage.

Subarachnoid hemorrhage can occur in people of all ages, but is more common in young and middle-aged people. It often occurs acutely when one is emotionally excited or exerting force, and some patients may have a history of recurrent headaches.

1. Headache and vomiting

Sudden severe headache, vomiting, pale face, and cold sweat all over the body. If the headache is localized to a certain area, it has localization significance. For example, anterior headache indicates supratentorial pain and cerebral hemisphere (unilateral pain), and posterior headache indicates lesions in the posterior cranial fossa.

2. Impairment of consciousness and mental symptoms

Most patients have no disturbance of consciousness, but may be irritable. Critically ill patients may experience delirium, varying degrees of unconsciousness, and even coma. A few may experience epileptic seizures and mental symptoms.

3. Meningeal irritation signs

It is more common and obvious in young and middle-aged patients, accompanied by neck and back pain. Elderly patients, those in the early stages of hemorrhage, or those in deep coma may not have signs of meningeal irritation.

4. Other clinical symptoms

Such as low fever, back pain and leg pain. Mild hemiplegia, visual impairment, paralysis of cranial nerves III, V, VI, VII, retinal hemorrhage and papilledema may also be seen. In addition, it may also be complicated by upper gastrointestinal bleeding and respiratory tract infection.

5. Laboratory examination

(1) Routine blood tests, routine urine tests and blood sugar. In the acute phase of severe subarachnoid hemorrhage, routine blood tests may show an increase in white blood cell count, and positive urine sugar and urine protein. The increase in blood sugar in the acute phase is caused by stress response. Increased blood sugar not only directly reflects the body's metabolic state, but also reflects the severity of the disease. The higher the blood sugar, the higher the incidence of complications such as stress ulcers, metabolic acidosis, and azotemia, and the worse the prognosis.

(2) Uniformly bloody cerebrospinal fluid is the main indicator for diagnosing subarachnoid hemorrhage. Pay attention to lumbar puncture immediately after onset. Since the blood has not yet entered the subarachnoid space, the cerebrospinal fluid is often negative. When the patient has obvious signs of meningeal irritation or a few hours after the patient has passed the lumbar puncture, the positive rate will increase significantly. The cerebrospinal fluid will show uniformly bloody content without clots. In most cases of subarachnoid hemorrhage, the cerebrospinal fluid pressure is elevated, mostly between 200 and 300 mmH2O. In some patients, the cerebrospinal fluid pressure is low, which may be due to blood clots blocking the subarachnoid space.

The protein content in the cerebrospinal fluid increases and can be as high as 1.0g/dl. The protein increase is greatest 8 to 10 days after the hemorrhage and then gradually decreases. The sugar and chloride contents in the cerebrospinal fluid are mostly within the normal range.

After subarachnoid hemorrhage, the white blood cells in the cerebrospinal fluid have three characteristic evolution processes in different periods. ① The blood cell reaction in the cerebrospinal fluid is mainly composed of neutrophils from 6 to 72 hours, which decreases significantly after 72 hours and gradually disappears after 1 week. ② Lympho-mononuclear phagocyte reaction appears on day 3 to 7, immune activated cells increase significantly, and erythrocyte phagocytes appear; ③ Hemosiderin-containing phagocytes begin to appear in the cerebrospinal fluid on day 3 to 7, gradually reaching a peak on day 14 to 28.

If you feel that you have the above symptoms, you must go to the hospital in time for medical treatment and do a full-body examination, preferably a brain CT scan. Although the incidence of this disease is not too high, it is a sudden disease and can be life-threatening if it suddenly occurs, so you must take precautions and check regularly in your daily life.