Traumatic Subarachnoid Hemorrhage: How a 38-Year-Old Woman Achieved Full Recovery with Conservative Treatment

When trauma strikes, even seemingly minor accidents can lead to serious medical conditions. This is the story of a 38-year-old woman who experienced a traumatic subarachnoid hemorrhage after a traffic incident and made a remarkable recovery through conservative treatment. Her journey highlights the importance of timely diagnosis, comprehensive care, and integrative therapies in neurological recovery.

Understanding Traumatic Subarachnoid Hemorrhage

Traumatic subarachnoid hemorrhage (tSAH) occurs when bleeding happens in the subarachnoid space—the area between the brain and the thin tissues that cover it—due to head injury. Unlike spontaneous cases often caused by aneurysms, tSAH results from external force, such as falls or vehicle collisions. Symptoms may include severe headache, dizziness, nausea, vomiting, and altered consciousness. Early detection and proper management are crucial for preventing complications and ensuring optimal recovery.

Patient Overview

Age & Gender: 38-year-old femaleDiagnosis: Traumatic subarachnoid hemorrhageHospital: Qingdao Hospital of Traditional Chinese MedicineDate of Admission: May 2022Treatment Duration: 2 weeks inpatient careTreatment Approach: Intravenous therapy combined with integrative TCM rehabilitation

The Initial Assessment

The patient, referred to as Ms. Li for privacy, was walking home from grocery shopping when she was struck by a passing car. The impact caused her to fall, landing on her right side with direct trauma to her head. Although she did not lose consciousness, she immediately experienced intense headaches, dizziness, nausea, and two episodes of vomiting. She also reported weakness in her limbs.

Emergency services were called, and she was rushed to the hospital via ambulance. Upon arrival at the emergency department, clinical evaluation revealed confusion, persistent nausea, and reduced muscle strength in all four limbs. A scalp laceration was cleaned and sutured, and an urgent CT scan of the brain confirmed traumatic subarachnoid hemorrhage along with a localized scalp hematoma. After consultation with a neurosurgery specialist, she was admitted for close monitoring and targeted treatment.

Comprehensive Treatment Plan

Once stabilized, Ms. Li began a multidisciplinary treatment protocol designed to support brain healing and prevent secondary injury. The approach included both conventional Western medicine and evidence-based Traditional Chinese Medicine (TCM) modalities.

Western Medical Interventions

In the first phase of treatment, intravenous medications were administered to address key aspects of neural recovery:

• Naloxone Hydrochloride Injection: To improve mental clarity and counteract central nervous system depression.
• Vitamin B6 Injection: For nerve nourishment and metabolic support.
• Citicoline Sodium Injection: To enhance neurotransmitter synthesis and aid in repairing damaged brain cells.
• Mannitol Injection: Used to reduce cerebral edema and lower intracranial pressure.

Regular blood tests monitored liver and kidney function, electrolyte balance, and coagulation status to maintain internal stability throughout recovery.

Integrative TCM Rehabilitation Therapies

On the second day of hospitalization, TCM specialists introduced complementary therapies aimed at accelerating recovery and improving overall well-being:

• Auricular Acupressure Pellets: Applied to specific points on the ear to regulate pain, sleep, and stress responses.
• Acupoint Application Therapy: Herbal patches placed on key meridian points to stimulate circulation and reduce inflammation.
• Medicated Foot Soak: Warm herbal baths used to promote relaxation, improve sleep quality, and enhance peripheral circulation.
• Acupuncture Sessions: Regular needle treatments focused on restoring energy flow and supporting neurological function.

A follow-up CT scan showed a noticeable reduction in intracranial bleeding. Encouraged by this progress, doctors scheduled an MRI to assess deeper brain structures. The MRI results were reassuring—no signs of cerebral contusion, and complete absorption of the hemorrhage was confirmed.

Recovery Outcomes and Discharge Progress

After two weeks of consistent, coordinated care, Ms. Li demonstrated significant improvement. Her mental status normalized, energy levels increased, and motor function fully returned. She regained the ability to walk independently and perform daily activities without assistance.

Final imaging studies confirmed full resolution of the hemorrhage with no residual brain damage. With all clinical indicators positive, she was discharged with a clean bill of health and successfully resumed her professional life within weeks.

Ongoing Care and Lifestyle Recommendations

While Ms. Li achieved a full recovery, long-term wellness remains essential. Here are key recommendations for patients recovering from similar injuries:

• Nutrition: Emphasize a balanced diet rich in antioxidants, omega-3 fatty acids, and B-vitamins to support brain repair.
• Physical Activity: Engage in low-impact exercises like walking, tai chi, or yoga to improve coordination and reduce stress.
• Avoid Harmful Habits: Eliminate smoking and alcohol consumption, which can impair cognitive recovery and increase stroke risk.
• Symptom Monitoring: Seek immediate medical attention if symptoms like headache, dizziness, blurred vision, or limb weakness reappear.

Clinical Insights and Key Takeaways

This case offers several important lessons for both patients and healthcare providers:

1. Never Underestimate Head Trauma

Even mild head impacts can result in internal bleeding. Any post-trauma symptoms—especially headache, nausea, or confusion—should prompt urgent medical evaluation.

2. Conservative Management Can Be Highly Effective

For mild to moderate tSAH without associated structural brain injury, non-surgical treatment is often sufficient. Close observation, medication, and supportive therapies can yield excellent outcomes.

3. Surgery Is Reserved for Severe Cases

Patients with large hematomas, brain contusions, or rising intracranial pressure may require surgical intervention. These decisions must be made by experienced neurosurgeons based on imaging and clinical progression.

4. Most Patients Make a Full Recovery

The majority of individuals with isolated tSAH recover completely. However, some may experience lingering symptoms such as fatigue or mild cognitive changes, requiring outpatient follow-up and potential neurorehabilitation support.

In conclusion, early diagnosis, integrated treatment strategies, and patient compliance play pivotal roles in achieving successful neurological recovery. As seen in this case, combining modern medicine with holistic approaches can optimize healing and empower patients to reclaim their lives after traumatic brain injury.