Is cerebral hemorrhage serious?

Written by Chen Yu Fei
Neurosurgery
Updated on September 02, 2024
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Brain hemorrhage is relatively serious. In most cases, the condition of patients with brain hemorrhage progresses quickly and worsens gradually, often leading to high rates of disability or mortality. Additionally, brain hemorrhages can affect the patient's level of consciousness, resulting in states of stupor or coma. On this basis, it is common for several complications to occur, such as significant pulmonary infections, acid-base imbalances, electrolyte disturbances, hypoproteinemia, or deep vein thrombosis in the lower limbs. These issues can easily cause patients to experience unilateral or bilateral limb paralysis, abnormal limb sensation accompanied by a decline in cognitive functions, aphasia, and other clinical manifestations.

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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 Chen Yu Fei
Neurosurgery
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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
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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 Jiang Fang Shuai
Neurosurgery
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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 Zhang Hui
Neurology
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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.