Complications of Cerebral Hemorrhage

Written by Chen Ya
Geriatrics
Updated on September 13, 2024
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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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Written by Jiang Fang Shuai
Neurosurgery
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Causes of cerebral hemorrhage

Any cause of cerebral vascular rupture and bleeding is called cerebral hemorrhage, including traumatic cerebral hemorrhage and non-traumatic cerebral hemorrhage. Traumatic cerebral hemorrhage, as the name suggests, is caused by head trauma, while the most common cause of non-traumatic cerebral hemorrhage is hypertension. Under the long-term impact of high blood pressure and high blood flow, numerous microaneurysms form in the brain's blood vessels. When blood pressure suddenly increases under certain conditions, these microaneurysms may rupture and bleed. The second most common cause is cerebral amyloid angiopathy, where blood vessels become aged, brittle, and weak, leading to rupture and bleeding. The third most common cause includes intracranial aneurysms and vascular malformations, which also partly cause hemorrhage. The fourth most common cause involves intracranial tumors, meningiomas, melanomas, and others. The fifth most common cause is related to hematological disorders, such as leukemia and deficiencies in clotting factors. Lastly, another cause is the prolonged use of anticoagulant and antiplatelet medications, which also contribute to cerebral hemorrhage.

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Written by Gao Yi Shen
Neurosurgery
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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.

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Written by Chen Ya
Geriatrics
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Cerebral hemorrhage CT manifestations

The CT manifestations of cerebral hemorrhage include, in the acute phase, the CT scan showing round or oval-shaped uniform high-density fresh hematoma with clear boundaries. It can determine the location, size, and shape of the hematoma, whether it has ruptured into the ventricle, and surrounding low-density edema. There are also effects of space-occupying lesions such as compression of the ventricles and brain tissue displacement, as well as obstructive hydrocephalus and other conditions where a large amount of blood in the ventricles contributes to high-density expansion. The hematoma's pressure on the surrounding brain tissue can lead to ischemia and commonly cause a characteristic ring-shaped low density due to edema around the hematoma.

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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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Written by Zhang Hui
Neurology
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What can be eaten with cerebral hemorrhage?

Intracerebral hemorrhage is an extremely dangerous neurological disease. Its onset is very sudden, with patients experiencing headaches, nausea, vomiting, as well as symptoms like limb paralysis, numbness, and speech impairments. Additionally, the gastrointestinal function of patients is significantly affected during an intracerebral hemorrhage, making them very susceptible to acute ulcers and acute gastric mucosal lesions. Hence, there are some precautions to consider regarding diet. In the acute phase of intracerebral hemorrhage, it is recommended to eat softer, easily digestible foods, such as rice porridge, millet porridge, sesame paste, etc., which are easier to digest and can help reduce the burden on the gastrointestinal tract. After the acute phase, the patient should consume more fresh vegetables and fruits, which can help maintain regular bowel movements, beneficial for the recovery from intracerebral hemorrhage. These also provide a rich source of vitamins that can protect vascular endothelial cells and reduce the recurrence of intracerebral hemorrhage. Additionally, eating high-quality proteins such as drinking milk, eating eggs, and lean meats can help enhance the patient's resistance and reduce complications.