Principles of Treatment for Cerebral Hemorrhage

Written by Chen Yu Fei

Neurosurgery

Updated on September 20, 2024

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For patients with cerebral hemorrhage, the main principle of treatment is to control the blood pressure in a relatively stable state. Blood pressure should not be too high or too low. If it is too low, it can easily lead to insufficient cerebral perfusion pressure, thus causing local cerebral tissue ischemia and hypoxia, leading to the occurrence of cerebral infarction. If the blood pressure is too high, it can easily exceed the regulatory function of the blood vessels, often causing secondary hemorrhage. Secondly, it is important to promptly monitor the patient's vital signs, observe the patient's consciousness, pupils, and limb movement, and timely perform a follow-up head CT scan to dynamically observe the changes in the patient's condition.

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Written by Chen Yu Fei

Neurosurgery

41sec

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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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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 Liu Yan Hao

Neurology

1min 7sec

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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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Written by Zhang Hui

Neurology

1min 5sec

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Early warning signs of cerebral hemorrhage

Cerebral hemorrhage is an emergency in neurology, typically presenting acutely with little to no warning signs. Patients usually experience rapid onset of symptoms including headache, nausea, vomiting, and paralysis of limbs. A detailed look at the patient's medical history may reveal some prodromal symptoms such as recent overexertion, emotional excitement, lack of rest, or constipation, which are common triggers. If a patient experiences repeated chronic headaches and general weakness, these could be the mechanical prodromal symptoms of cerebral hemorrhage. A significant fluctuation in blood pressure should also raise concerns about the possibility of a cerebral hemorrhage. Once a cerebral hemorrhage occurs, it is crucial to promptly seek hospital treatment. If the volume of the hemorrhage is substantial, it poses a life-threatening risk to the patient and surgical treatment may be necessary. If the hemorrhage is smaller, conservative treatment may suffice, focusing on bed rest, maintaining emotional stability, and administering neuroprotective medications.

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Written by Chen Ya

Geriatrics

39sec

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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.