How is cerebral hemorrhage treated?

Written by Chen Yu Fei

Neurosurgery

Updated on September 10, 2024

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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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Written by Tang Li Li

Neurology

55sec

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What are the symptoms of cerebral hemorrhage?

Patients with cerebral hemorrhage typically experience sudden headaches during physical activity or emotional excitation as their initial symptom, which may be accompanied by nausea and vomiting. In severe cases, vomiting can be projectile, consisting of stomach contents. If the patient has stress ulcers leading to bleeding and erosion of the gastric mucosa, they may vomit a coffee-ground-like liquid, which is a mixture of gastric juices and blood. Additionally, patients may also exhibit disturbances in consciousness, such as drowsiness, stupor, or even coma. If the patient is conscious, one may observe hemiplegia or paralysis, sometimes accompanied by speech impairments or psychiatric symptoms. Some patients may also experience epileptic seizures.

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Written by Zhang Hui

Neurology

1min 12sec

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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.

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Written by Jiang Fang Shuai

Neurosurgery

1min 15sec

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How is cerebral hemorrhage treated?

The treatment for brain hydrocephalus includes conservative medical treatment and surgical intervention. Conservative medical treatment is primarily for patients with a lesser amount of bleeding, using methods such as hemostasis, brain protection, dehydration to reduce intracranial pressure, and maintaining electrolyte balance for symptomatic support treatment. For bedridden patients, it's also necessary to prevent and treat various complications such as pulmonary infections, urinary system infections, and venous thrombosis. Surgical treatment is mainly for patients with a larger volume of bleeding, approximately 30mL of cerebrospinal fluid bleeding, cerebellar bleeding over 10mL, or cerebellar bleeding less than 10mL but causing brainstem compression. Patients with hydrocephalus should actively consider surgery to remove the hematoma. The decision to perform decompressive craniectomy is based on preoperative and intraoperative findings. In some cases, where the brain compression is not severe, or in elderly patients who have poor tolerance for surgery, minimally invasive surgery to remove the hematoma may be considered.

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Written by Chen Yu Fei

Neurosurgery

44sec

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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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Written by Chen Ya

Geriatrics

55sec

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How to recover from cerebral hemorrhage

The recovery from cerebral hemorrhage is divided into the acute phase and the non-acute phase. In the acute phase, if there is a large amount of bleeding and increased intracranial pressure, surgical intervention can be considered. If the bleeding is less but intracranial pressure is still high, general treatment includes managing blood pressure well, maintaining it at 140 systolic pressure, under which conditions things generally tend to be better. Additionally, controlling intracranial pressure and treatment to stop the bleeding are needed. Later stages involve anticoagulant reversal treatments and prevention of complications because infections, high blood sugar, and stress ulcers can further worsen the condition. The later stages primarily focus on rehabilitation training treatments, helping with limb and speech rehabilitation training.