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Intracerebral hemorrhage
What causes cerebral hemorrhage?
Brain hemorrhage is a common problem that can be caused by many phenomena. The most common causes include hypertension and arteriosclerosis, which can lead to the rupture of blood vessels and consequently brain hemorrhage. Other cerebrovascular abnormalities, such as vascular malformations, cavernous angiomas, or intracranial aneurysms can also lead to brain hemorrhage. Additionally, brain tumors that rupture can cause hemorrhage, as can conditions where there are issues with blood coagulation function and poor clotting times. Some patients may experience brain hemorrhage due to cerebral lipoid degeneration, and trauma can also cause brain hemorrhage.
Preliminary symptoms of cerebral hemorrhage
Cerebral hemorrhage is a severe and sudden onset condition that usually starts without any prodromal symptoms, manifesting as hemiplegia, severe headaches, or even coma. However, some patients may exhibit certain early symptoms, which mainly include: First, headache, which is not particularly severe, is tolerable, but typically affects the forehead and both temporal areas. Second, patients generally have very high, hard-to-control blood pressure. If the blood pressure is extremely high and difficult to manage, the possibility of cerebral hemorrhage should be considered. Third, in the early stages of cerebral hemorrhage, patients may experience symptoms such as dizziness, blurred vision, and general weakness. Overall, the early symptoms of cerebral hemorrhage are not particularly typical. If a patient with high blood pressure becomes hard to manage, experiences slight headaches, dizziness, blurred vision, and some nausea, these may be indicative of the early symptoms of cerebral hemorrhage.
Early warning signs of cerebral hemorrhage
Cerebral hemorrhage is an emergency in neurology, typically presenting acutely with little to no warning signs. Patients usually experience rapid onset of symptoms including headache, nausea, vomiting, and paralysis of limbs. A detailed look at the patient's medical history may reveal some prodromal symptoms such as recent overexertion, emotional excitement, lack of rest, or constipation, which are common triggers. If a patient experiences repeated chronic headaches and general weakness, these could be the mechanical prodromal symptoms of cerebral hemorrhage. A significant fluctuation in blood pressure should also raise concerns about the possibility of a cerebral hemorrhage. Once a cerebral hemorrhage occurs, it is crucial to promptly seek hospital treatment. If the volume of the hemorrhage is substantial, it poses a life-threatening risk to the patient and surgical treatment may be necessary. If the hemorrhage is smaller, conservative treatment may suffice, focusing on bed rest, maintaining emotional stability, and administering neuroprotective medications.
How to Prevent Cerebral Hemorrhage
To understand how to prevent cerebral hemorrhage, we need to clarify what causes it. Generally, the most common cause of cerebral hemorrhage is hypertension. Long-term hypertension can lead to hyaline degeneration of the walls of small arteries and occlusion necrosis. Over time, small arteries rupture, leading to cerebral hemorrhage. Other blood system diseases, such as leukemia, deficiency of clotting factors, some tumors, and cerebral vascular malformations, can also cause cerebral hemorrhage. Therefore, the most important preventive measure is to actively control blood pressure. Regularly, one must maintain a low-salt, low-fat diet, engage in appropriate physical activities, enhance physical fitness, avoid smoking, and abstain from alcohol to effectively prevent hypertension and avoid hypertension-induced cerebral hemorrhage. For cerebral hemorrhage caused by other reasons, regular health check-ups should be done, including complete blood counts and coagulation tests, to rule out blood diseases causing cerebral hemorrhage.
Sequelae of cerebral hemorrhage
The most common sequelae of cerebral hemorrhage is hemiplegia, which is specifically characterized by reduced muscle strength in the limbs on one side, difficulty in movement or complete immobility, often accompanied by sensory impairments on the same side, such as reduced sensation to cold, heat, pain, etc., or complete numbness. Sometimes there may also be vision loss on the affected side, as well as aphasia, headache, vertigo, and nausea.
What are the symptoms of cerebral hemorrhage?
For patients with cerebral hemorrhage, the symptoms vary clinically due to different amounts of bleeding and instability of the hemorrhage, which affect the surrounding brain tissue to different extents. For patients with minor cerebral hemorrhage, the impact is generally minor, and most patients only exhibit mild symptoms such as headache, dizziness, nausea, and retching. For patients with larger bleeding volumes located in crucial motor and speech functional areas, they often show symptoms such as unilateral limb paralysis and abnormal sensations in the affected limbs, accompanied by significant headaches, dizziness, reduced intellectual levels, cognitive impairments, and even aphasia.
Is cerebral hemorrhage serious?
The critical period for cerebral hemorrhage is generally around 14 days, as it primarily involves overcoming two most dangerous phases. The first phase is within three days of the cerebral hemorrhage. This period is most feared for the potential increase in bleeding. Often, if blood pressure is not well controlled, it can easily lead to further bleeding, especially within the first three days which has the highest incidence. The second phase is approximately 10-14 days after the cerebral hemorrhage, because this period marks the peak of cerebral swelling and cerebral vasospasm. The main concern here is severe cerebral swelling and cerebral vasospasm, which can lead to cerebral infarction, and potentially extensive cerebral infarction, possibly resulting in death. Trepanation surgery may be necessary to save the patient.
Is cerebral hemorrhage dangerous?
Cerebral hemorrhage is a type of acute cerebrovascular accident and is quite dangerous. The risk associated with cerebral hemorrhage is directly related to the amount of bleeding and the location of the bleed. Generally, if it is an ordinary lobar hemorrhage and the volume of blood is less than 30 milliliters, the risk is relatively low, and conservative medical treatment may be sufficient. However, if the bleeding exceeds 30 milliliters, there is an indication for surgery. Without surgery, conservative treatment may lead to an increase in hematoma and progressive surrounding edema, which could compress the brainstem, cause brain herniation, and lead to respiratory and circulatory failure, posing a life-threatening risk. Hemorrhages in the brainstem and cerebellum are even more dangerous. The brainstem is the center of vital functions, including the centers for breathing and heart rate. Typically, a bleeding volume exceeding 5 milliliters in the brainstem can lead to patient death. Since the cerebellum is close to the brainstem and might compress it, a bleeding volume exceeding 10 milliliters in the cerebellum often warrants consideration for surgery.
What should be done about cerebral hemorrhage?
Cerebral hemorrhage is a relatively serious disease. After a cerebral hemorrhage occurs, patients usually experience noticeable headaches, nausea, and vomiting. The onset is relatively rapid, and it may present clinical symptoms such as slurred speech, deviation of the mouth, and paralysis of one side of the body. In severe cases, the patient may become comatose or even die. Once diagnosed with cerebral hemorrhage, it is necessary to immediately rush to the nearest hospital for treatment. It is important to ensure the patient rests in bed, keeps their emotions stable, avoids emotional excitement, and maintains regular bowel movements without straining. If cerebral hemorrhage causes increased intracranial pressure, dehydration medications to reduce intracranial pressure can be used. Additionally, medications to protect brain cells should be used. It is crucial to actively control the patient's blood pressure and, when the condition stabilizes, to perform regular rehabilitative exercises to promote the recovery of neurological functions. If the volume of the cerebral hemorrhage is large and threatens the patient's life, neurosurgery may be needed to save the patient's life.
Is cerebral hemorrhage dangerous?
Cerebral hemorrhage damages the central nervous system, which is our command center. Once the command center is damaged, a person's respiration, blood pressure, pulse, heartbeat, body temperature, movement, sensation, digestion, and other vital activities will be affected. The common sites for cerebral hemorrhage are in the basal ganglia, cerebrospinal fluid, pons, and cerebellum. These regions are usually important brain functional areas. Therefore, although advanced medical technology is available for treating patients with cerebral hemorrhage, the mortality and disability rates are still relatively high. Cerebral hemorrhage is a dangerous disease.