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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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.

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Causes of cerebral hemorrhage

The most common cause of cerebral hemorrhage is hypertensive cerebral hemorrhage. Patients with hypertension who do not adequately control their blood pressure, which frequently fluctuates, can lead to hardening of the cerebral vessels. The elasticity of the cerebral vessel walls diminishes, and when the blood pressure rises sharply, it can cause the cerebral vessels to rupture, leading to cerebral hemorrhage. This is the most common cause of cerebral hemorrhage, accounting for over 80%. Another common cause of cerebral hemorrhage is the rupture of cerebral aneurysms, which often leads to subarachnoid hemorrhage. Patients with this condition experience severe headaches, consciousness disturbances, and restlessness. Subarachnoid hemorrhage is a relatively severe medical condition with a high mortality rate. Additionally, some cerebral hemorrhages are caused by trauma, leading to cerebral contusion, skull fractures, subdural hematoma, and epidural hematoma. These causes account for a relatively small proportion of clinical cases.

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How is cerebral hemorrhage treated?

For patients with cerebral hemorrhage, the first step is to urgently send the patient to the local hospital for medical attention and head CT scans. This primarily determines the current location of the hemorrhage, the severity of the bleeding, including the number of intracerebral hematomas. If there are multiple intracerebral hematomas causing significant mass effect and substantial compression on the surrounding brain tissue, leading to neurological damage, emergency surgical treatment is generally recommended. If the bleeding is minor with no significant mass effect, conservative treatment is advised. Treatment can include hemostasis, brain health promotion, nerve nutrition, acid suppression, and prevention of lung infections, among other approaches.

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Complications of Cerebral Hemorrhage

The main complications of cerebral hemorrhage are infections or fever, especially aspiration pneumonia, which is quite common. The second complication is hyperglycemia. The third is stress ulcers and gastrointestinal bleeding. The fourth complication involves cardiac issues, as patients with cerebral hemorrhage are prone to neurogenic cardiac damage. Another complication is epilepsy; patients with lobar hemorrhage are likely to experience recurrent seizures. Additionally, there is also central fever.

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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.