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A time bomb in the brain: How to recognize the signs of submeningeal hemorrhage?
Subarachnoid Hemorrhage (SAH) is a potentially fatal medical condition in which bleeding occurs in the area between the arachnoid membrane and the pia mater that surround the brain. Symptoms of this condition include severe headaches, vomiting, decreased level of consciousness, fever, weakness, numbness, and sometimes even seizures. Neck stiffness or neck pain are also common symptoms. In addition, about a quarter of patients experience minor bleeding with relief of symptoms within a month of experiencing a major bleed.
Most cases of submeningeal hemorrhage are caused by head trauma or a spontaneously ruptured cerebral aneurysm. Risk factors for spontaneous conditions include hypertension, smoking, family history, alcohol abuse, and cocaine use.
It is crucial to recognize the symptoms of submeningeal hemorrhage early. Headaches are often described as "like being kicked in the head" and are also called thunderclap headaches. This headache can develop quickly, within seconds to minutes, and often strikes the back of the head (temporofrontal).
Statistics on headaches show that about one-third of patients with submeningeal hemorrhage have no symptoms other than the characteristic headache, and about one in ten cases who seek help from medical institutions will be later diagnosed with meningeal hemorrhage. Bleeding below.
Doctors usually begin the diagnosis process with a CT scan of the head, which is highly effective in detecting submeningeal hemorrhage within six hours of symptom onset. In addition, other possible causes, such as migraine or cerebral venous sinus thrombosis, are also considered during the diagnosis. Lumbar puncture also becomes necessary in the setting of normal findings on noncontrast CT because it can reveal the presence of hemorrhage. Once the diagnosis is confirmed, your doctor will further evaluate the underlying cause of the bleeding.
Symptoms and causes of submeningeal hemorrhage
Symptoms of a submeningeal hemorrhage can vary greatly but usually include headache, confusion, and a stiff neck. Because these symptoms can be easily confused with other illnesses, medical professionals must be careful to differentiate them. Of all cases of spontaneous submeningeal hemorrhage, 85% are caused by cerebral aneurysms, while the remainder may include other vascular abnormalities or bleeding from malignant tumors.
For patients with high-risk factors, once the above symptoms appear, timely medical treatment will be the key to saving lives.
The diagnosis of submeningeal hemorrhage usually requires specific imaging tests such as CT or MRI. CT scan is the test of choice for detecting submeningeal hemorrhage, especially within the first six hours of symptom onset. In contrast, the sensitivity of MRI increases over several days compared to CT.
Diagnosis and treatment
Early diagnosis of submeningeal hemorrhage is crucial. Once the diagnosis is confirmed, follow-up treatment is considered to prevent further bleeding, usually requiring emergency surgery. A specialized neurosurgeon will perform either endovascular embolization or surgery, depending on the nature and location of the bleeding.
Antihypertensive drugs are often used to maintain blood pressure within a safe range until repair surgery can be done. Calcium channel blockers are also used to help prevent blood vessel spasms.
The patient's vital signs also need to be continuously monitored during treatment to ensure that no other complications arise during treatment. Electrocardiographic changes are also relatively common and include arrhythmias and QT interval prolongation. These may be related to high adrenaline concentrations in the brain and require the high attention of medical personnel.
Reconstruction and rehabilitation
Patients who experience a submeningeal hemorrhage may face a poor quality of life, particularly those who are hospitalized to the point where mental function and physical activity are affected. For these patients, rehabilitation programs should include professional physical therapy and psychological support to help them reintegrate into daily life.
According to statistics, only about 50% of patients survive a submeningeal hemorrhage, but many of them face long-term physical and mental challenges.
For the prevention of submeningeal hemorrhage, although public screening is not common, people with a family history or patients with high risk factors such as renal cystic disease may need regular examinations. These additional screening tests may help detect potential aneurysms early to prevent possible submeningeal hemorrhage.
Submeningeal hemorrhage is undoubtedly an emergency that requires careful management. After understanding these symptoms, will you pay more attention to changes in your body's signals when you face a severe headache?
