Spontaneous subarachnoid hemorrhage 1.Definition of spontaneous subarachnoid hemorrhage refers to non-traumatic rupture of intracranial blood vessels and direct flow of blood into the subarachnoid space, also known as primary subarachnoid hemorrhage. 2, What causes spontaneous subarachnoid hemorrhage? Many causes can cause spontaneous subarachnoid hemorrhage, the main and most serious of which is cerebral aneurysm rupture, accounting for about 85%. Other causes include cerebrovascular malformation, hematologic disorders, non-aneurysmal pericentral hemorrhage, etc. 3, clinical manifestations of spontaneous subarachnoid hemorrhage Before the onset of the disease, there are mostly obvious triggers: such as strenuous exercise, overwork, excitement, defecation, coughing, alcohol consumption, etc.; a few may develop in a quiet state. The main symptom is a sudden onset of significant or unusual unbearable severe headache, which can be at any location, unilateral or bilateral. It is accompanied by nausea and vomiting, neck pain, blurred vision, and in severe cases, loss of consciousness and unconsciousness. 4.What tests are needed? Once a spontaneous subarachnoid hemorrhage is suspected, a cranial CT must be performed immediately to clarify the diagnosis. In a few cases where CT is not clear, lumbar cerebrospinal fluid examination can be done. Once a subarachnoid hemorrhage is confirmed, a CTA, or cerebral angiogram (DSA), must be performed to identify the presence of a lesion such as an aneurysm. If the first angiogram does not reveal the cause of the hemorrhage, a second angiogram is needed 2 weeks later to avoid missing the lesion. 5. Treatment measures When an aneurysm or other lesion is found on angiography, doctors who have knowledge of surgical techniques and neurointerventional techniques should consult with each other and decide together how to treat it as the best plan. Once the decision is made, surgery or intervention should be given as soon as possible to avoid rebleeding. During treatment, the following should be noted: (1) Absolute bed rest to keep the patient stable and reduce the risk of intracranial hemorrhage; (2) Reduce visits by visitors and soft room lighting to reduce stimulation to the patient; (3) Avoid emotional excitement and sudden exertion, and keep bowel movements smooth; (4) Encourage the patient to eat small and frequent meals with easily digestible and nutritious food; (5) Closely observe the patient. (5) Closely observe the patient’s consciousness, pupils, body temperature, pulse rate, respiration, blood pressure and other vital signs; (6) Prohibit smoking and alcohol, eat less spicy food, and eat less oil-pickled products.