How is cerebral hemorrhage treated?

Written by Jiang Fang Shuai
Neurosurgery
Updated on September 12, 2024
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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 Tang Li Li
Neurology
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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 Jiang Fang Shuai
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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Written by Chen Ya
Geriatrics
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Sequelae of cerebral hemorrhage

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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Written by Tang Li Li
Neurology
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Does cerebral hemorrhage have a genetic basis?

Cerebral hemorrhage is not hereditary and is not a genetic disease; it is a type of acute cerebrovascular disease. Its occurrence is related to risk factors of cerebrovascular disease, and some risk factors may be related to genetics. Therefore, having a family history of cerebral hemorrhage is considered one of the factors that can increase the incidence rate of cerebral hemorrhage in patients. For example, if a patient's parents have hypertension, diabetes, or hyperlipidemia, these risk factors can significantly increase the likelihood that the patient will also develop these conditions as they age. Long-term hypertension, diabetes, and hyperlipidemia can lead to arterial wall hardening, sometimes resulting in hyaline degeneration. When blood pressure fluctuates, it can easily form microaneurysms that rupture and bleed, thus causing cerebral hemorrhage. Therefore, although cerebral hemorrhage itself is not hereditary, hereditary-related conditions such as hypertension and diabetes might lead to its occurrence.

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Written by Zhang Hui
Neurology
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How to care for cerebral hemorrhage

Cerebral hemorrhage is a very dangerous neurological disease. In addition to conducting related drug treatments to control the condition, prevent the enlargement of the hemorrhage, and prevent the recurrence of cerebral thrombosis, nursing care is also very important. The nursing of cerebral hemorrhage mainly includes the following aspects: First, it is essential to address the patient's mental state and soothe their emotions because large emotional fluctuations can easily lead to an increase in the amount of cerebral hemorrhage. Second, patients should be advised to rest in bed and avoid vigorous activities. Early ambulation can also easily lead to an increase in cerebral hemorrhage. Third, it is important to maintain smooth bowel movements. If the bowel movements are not smooth, or even constipated, excessive straining during defecation can cause an increase in cerebral hemorrhage. Fourth, patients with cerebral hemorrhage often have some associated complications, such as pulmonary infections and acute ulcers, among other diseases. It is crucial for patients to be attentive to turning over, patting the back, suctioning phlegm, and administering antibiotics in a timely manner if necessary. For the prevention of acute gastric mucosal lesions and acute ulcers, patients should eat soft, easily digestible food.