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Intracerebral hemorrhage
Can a secondary hemorrhage from cerebral hemorrhage be saved?
Although the mortality rate for secondary hemorrhage of cerebral hemorrhage is relatively high, there is still hope for recovery if medical attention is sought in time and aggressive treatment is administered. For instance, those with large amounts of hemorrhage can undergo surgical treatment in neurosurgery, while those with smaller amounts of bleeding can receive conservative treatment. Generally, the smaller the amount of bleeding, the greater the likelihood of survival.
Causes of cerebral hemorrhage
Any cause of cerebral vascular rupture and bleeding is called cerebral hemorrhage, including traumatic cerebral hemorrhage and non-traumatic cerebral hemorrhage. Traumatic cerebral hemorrhage, as the name suggests, is caused by head trauma, while the most common cause of non-traumatic cerebral hemorrhage is hypertension. Under the long-term impact of high blood pressure and high blood flow, numerous microaneurysms form in the brain's blood vessels. When blood pressure suddenly increases under certain conditions, these microaneurysms may rupture and bleed. The second most common cause is cerebral amyloid angiopathy, where blood vessels become aged, brittle, and weak, leading to rupture and bleeding. The third most common cause includes intracranial aneurysms and vascular malformations, which also partly cause hemorrhage. The fourth most common cause involves intracranial tumors, meningiomas, melanomas, and others. The fifth most common cause is related to hematological disorders, such as leukemia and deficiencies in clotting factors. Lastly, another cause is the prolonged use of anticoagulant and antiplatelet medications, which also contribute to cerebral hemorrhage.
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.
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.
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.
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.
Causes of cerebral hemorrhage
There are many causes of cerebral hemorrhage. In most cases, given that patients themselves already have certain underlying diseases, such as hypertension, diabetes, coronary heart disease, and arteriosclerosis, the blood pressure remains high over a long period. This causes the blood vessels to be in a constant state of tension. Over time, the vessels' ability to regulate and contract gradually weakens. When certain triggers occur, such as the patient experiencing fatigue, mental stress, or emotional excitement, the blood pressure temporarily spikes, exceeding the vessels' regulatory capacity, leading to the rupture of the blood vessels and causing cerebral hemorrhage.
How is cerebral hemorrhage treated?
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.
Is cerebral hemorrhage serious?
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.
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.