Sequelae of cerebral hemorrhage

Written by Chen Ya
Geriatrics
Updated on September 27, 2024
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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.

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Neurology
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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.

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Neurosurgery
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Causes of cerebral hemorrhage

There are many causes of cerebral hemorrhage. In most cases, given that patients themselves already have certain underlying diseases, such as hypertension, diabetes, coronary heart disease, and arteriosclerosis, the blood pressure remains high over a long period. This causes the blood vessels to be in a constant state of tension. Over time, the vessels' ability to regulate and contract gradually weakens. When certain triggers occur, such as the patient experiencing fatigue, mental stress, or emotional excitement, the blood pressure temporarily spikes, exceeding the vessels' regulatory capacity, leading to the rupture of the blood vessels and causing cerebral hemorrhage.

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Written by Chen Ya
Geriatrics
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Can a secondary hemorrhage from cerebral hemorrhage be saved?

Although the mortality rate for secondary hemorrhage of cerebral hemorrhage is relatively high, there is still hope for recovery if medical attention is sought in time and aggressive treatment is administered. For instance, those with large amounts of hemorrhage can undergo surgical treatment in neurosurgery, while those with smaller amounts of bleeding can receive conservative treatment. Generally, the smaller the amount of bleeding, the greater the likelihood of survival.

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Neurosurgery
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What is cerebral hemorrhage?

The term "cerebral hemorrhage" usually refers to bleeding caused by non-traumatic rupture of brain blood vessels. The causes include hypertension, arteriosclerosis, amyloid angiopathy, and vascular malformations, among others, often occurring during excessive fatigue, emotional excitement, or strenuous defecation. Clinically, it has a high rate of self-harm, and most survivors suffer from varying degrees of brain dysfunction. Additionally, some cases of cerebral hemorrhage are caused by trauma; the treatment principles and prognosis for these patients are similar to those for non-traumatic cerebral hemorrhages.

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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.