What causes cerebral hemorrhage?

Written by Zhang Jin Chao
Neurosurgery
Updated on December 05, 2024
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Brain hemorrhage is a common problem that can be caused by many phenomena. The most common causes include hypertension and arteriosclerosis, which can lead to the rupture of blood vessels and consequently brain hemorrhage. Other cerebrovascular abnormalities, such as vascular malformations, cavernous angiomas, or intracranial aneurysms can also lead to brain hemorrhage. Additionally, brain tumors that rupture can cause hemorrhage, as can conditions where there are issues with blood coagulation function and poor clotting times. Some patients may experience brain hemorrhage due to cerebral lipoid degeneration, and trauma can also cause brain hemorrhage.

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How to Prevent Cerebral Hemorrhage

To understand how to prevent cerebral hemorrhage, we need to clarify what causes it. Generally, the most common cause of cerebral hemorrhage is hypertension. Long-term hypertension can lead to hyaline degeneration of the walls of small arteries and occlusion necrosis. Over time, small arteries rupture, leading to cerebral hemorrhage. Other blood system diseases, such as leukemia, deficiency of clotting factors, some tumors, and cerebral vascular malformations, can also cause cerebral hemorrhage. Therefore, the most important preventive measure is to actively control blood pressure. Regularly, one must maintain a low-salt, low-fat diet, engage in appropriate physical activities, enhance physical fitness, avoid smoking, and abstain from alcohol to effectively prevent hypertension and avoid hypertension-induced cerebral hemorrhage. For cerebral hemorrhage caused by other reasons, regular health check-ups should be done, including complete blood counts and coagulation tests, to rule out blood diseases causing cerebral hemorrhage.

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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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Is cerebral hemorrhage serious?

The critical period for cerebral hemorrhage is generally around 14 days, as it primarily involves overcoming two most dangerous phases. The first phase is within three days of the cerebral hemorrhage. This period is most feared for the potential increase in bleeding. Often, if blood pressure is not well controlled, it can easily lead to further bleeding, especially within the first three days which has the highest incidence. The second phase is approximately 10-14 days after the cerebral hemorrhage, because this period marks the peak of cerebral swelling and cerebral vasospasm. The main concern here is severe cerebral swelling and cerebral vasospasm, which can lead to cerebral infarction, and potentially extensive cerebral infarction, possibly resulting in death. Trepanation surgery may be necessary to save the patient.

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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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Preliminary symptoms of cerebral hemorrhage

Cerebral hemorrhage is a severe and sudden onset condition that usually starts without any prodromal symptoms, manifesting as hemiplegia, severe headaches, or even coma. However, some patients may exhibit certain early symptoms, which mainly include: First, headache, which is not particularly severe, is tolerable, but typically affects the forehead and both temporal areas. Second, patients generally have very high, hard-to-control blood pressure. If the blood pressure is extremely high and difficult to manage, the possibility of cerebral hemorrhage should be considered. Third, in the early stages of cerebral hemorrhage, patients may experience symptoms such as dizziness, blurred vision, and general weakness. Overall, the early symptoms of cerebral hemorrhage are not particularly typical. If a patient with high blood pressure becomes hard to manage, experiences slight headaches, dizziness, blurred vision, and some nausea, these may be indicative of the early symptoms of cerebral hemorrhage.