OVERVIEW
Overview of traumatic subarachnoid hemorrhage
Traumatic subarachnoid hemorrhage refers to the contusion of brain tissue, bleeding from damage to small blood vessels, and blood flow into the subarachnoid space after craniocerebral trauma, often accompanied by skull fracture. Craniocerebral trauma is the most common cause of subarachnoid hemorrhage. Depending on the location of the hemorrhage and the amount of bleeding, there can be different manifestations.
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Department
Neurosurgery
Clinical symptoms
Headache, nausea, vomiting, impaired consciousness, convulsions, signs of meningeal irritation, and limb movement disorders.
Hazards
Hemorrhage may induce vasospasm, cerebral edema, or may be combined with life-threatening craniocerebral injury.
Examination
CT, cerebrospinal fluid examination, etc.
Diagnosis
Diagnosis is based on history of trauma, headache, nausea, vomiting, impaired consciousness, convulsions, signs of meningeal irritation, etc., combined with CT examination.
Treatment principle
Symptomatic treatment and surgery if necessary.
Cure
Symptoms can be improved after active treatment, and there is no neurological dysfunction after absorption of hemorrhage.
Dietary advice
Eat more fresh vegetables and fruits, avoid stimulating food, quit smoking and alcohol.
Causes
Causes
This disease is caused by craniocerebral trauma.
Symptoms and Diagnosis
Typical symptoms
1. Symptoms
The most common symptoms are sudden onset of headache, nausea, vomiting, impaired consciousness, convulsions, and psychiatric symptoms. In mild cases, headache, vomiting and meningeal irritation signs appear l-2 d after injury and last for l-2 weeks. In severe cases, there are consciousness disorders such as agitation, trance, disorientation, or even coma, high fever, epilepsy, and cerebral ischemic symptoms.
2. Signs
The most common signs are meningeal irritation sign, limb movement disorder and cranial nerve damage.
Diagnostic basis
1.Medical history
History of head trauma.
2.Clinical manifestations
Severe headache, dizziness, nausea, vomiting and meningeal irritation.
3. Auxiliary examination
Craniocerebral CT examination shows signs of high-density hemorrhage in the subarachnoid space, high-density shadow of cortical spots, and high-density shadow of cerebral pools and sulci, mostly located in the lateral cerebral fissure, anterior longitudinal fissure pool, posterior longitudinal fissure pool, supra-saddle pool, and circumflex pool, etc. The CT scan can clearly show the location and degree of hemorrhage, and it can be used to observe the condition in a dynamic manner.
Treatment
Treatment guidelines
Symptomatic treatment or surgery.
Drug treatment
1. Appropriate analgesics or sedatives are given to relieve symptoms in mild cases.
2. Give drugs to dehydrate and reduce intracranial pressure, such as mannitol.
3. Use calcium antagonists, such as low molecular dextrose and danshen.
Surgical treatment
When combined with craniocerebral injury, compound indications can be considered craniotomy treatment.
Other treatments
Release and replacement therapy of bloody cerebrospinal fluid.
Prognosis
The prognosis depends on the site of bleeding and the amount of bleeding, and most have a good prognosis if there is no combined brain tissue damage. The disability rate is about 50%.
Nursing care
Daily care
1. Maintain emotional stability and avoid overwork.
2. Keep the environment quiet and comfortable, and keep the light in the room dark.
3. Take medication as prescribed by the doctor and have regular checkups.
Diet
Eat more fresh vegetables and fruits, avoid stimulating food, quit smoking and drinking.