Treatment and Nursing Care for Traumatic Subarachnoid Hemorrhage

Understanding Traumatic Subarachnoid Hemorrhage

Tragic subarachnoid hemorrhage (tSAH) is a serious neurological condition that occurs when bleeding develops in the subarachnoid space—located between the brain and the tissues covering it—due to head trauma. This type of hemorrhage often results from falls, car accidents, or sports-related injuries. The severity of tSAH varies widely, depending on the volume of blood, the location of the bleed, and whether there are associated brain injuries.

Treatment Approaches Based on Severity

For mild cases involving minimal bleeding, the primary treatment focuses on stabilization and close monitoring. Patients typically receive medications to control blood pressure, prevent seizures, and manage pain. Antifibrinolytic agents may also be used to reduce further bleeding. In these situations, surgical intervention is usually not required, and recovery can occur with conservative management.

In more severe cases where significant bleeding is present, prompt surgical evaluation becomes critical. Neurosurgeons may perform procedures such as craniotomy or aneurysm clipping if a vascular abnormality is identified. The goal is to relieve intracranial pressure, remove blood clots, and prevent secondary complications like cerebral vasospasm or hydrocephalus. Early diagnosis and timely surgery significantly improve patient outcomes.

Factors Influencing Recovery and Cure Rates

The prognosis for traumatic subarachnoid hemorrhage depends on several key factors: the extent of bleeding, the specific area of the brain affected, the presence of additional injuries (such as contusions or edema), and whether complications develop. When tSAH is isolated and treated promptly without major neurological damage, the chances of full recovery are relatively high. However, delayed treatment or extensive brain injury can lead to long-term disabilities or increased mortality risk.

Comprehensive Nursing and Supportive Care

Continuous neurological monitoring is essential during the acute phase. Nurses must regularly assess vital signs, pupil response, and level of consciousness—key indicators of potential changes in intracranial pressure. Any sudden deterioration in mental status or unequal pupil size should trigger immediate medical review, as these may signal worsening brain swelling or herniation.

Managing Daily Living and Rehabilitation

Patients who experience motor deficits due to nerve dysfunction require early intervention through physical and occupational therapy. Even in the initial stages of recovery, passive range-of-motion exercises can help maintain joint flexibility and prevent contractures. As strength improves, structured rehabilitation programs are introduced to enhance mobility, coordination, and independence.

Nursing care also extends to psychological support, nutritional management, and preventing common hospital-acquired conditions such as deep vein thrombosis, pneumonia, and pressure ulcers. A multidisciplinary team approach—including neurologists, therapists, dietitians, and mental health professionals—plays a crucial role in optimizing recovery and improving quality of life post-injury.