Can a secondary hemorrhage from cerebral hemorrhage be saved?

Written by Chen Ya
Geriatrics
Updated on September 16, 2024
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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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Symptoms of cerebral hemorrhage

For patients with cerebral hemorrhage, the specific symptoms that appear depend on the location and amount of the bleed. For example, if the bleeding is in an important area for motor function, such as bilateral bleeding in the basal ganglia region, it often leads to contralateral hemiplegia in the patient, and is likely to be accompanied by abnormal sensations in the affected limbs. Additionally, if the bleeding is located in the language function area, the patient may exhibit impaired language functions, such as speech disorders, slurred speech, and difficulty speaking. Furthermore, conditions such as anomia, motor aphasia, or mixed aphasia may also occur.

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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.

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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 Yu Fei
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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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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.