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 Ya
Geriatrics
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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.

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Written by Chen Ya
Geriatrics
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Cerebral hemorrhage CT manifestations

The CT manifestations of cerebral hemorrhage include, in the acute phase, the CT scan showing round or oval-shaped uniform high-density fresh hematoma with clear boundaries. It can determine the location, size, and shape of the hematoma, whether it has ruptured into the ventricle, and surrounding low-density edema. There are also effects of space-occupying lesions such as compression of the ventricles and brain tissue displacement, as well as obstructive hydrocephalus and other conditions where a large amount of blood in the ventricles contributes to high-density expansion. The hematoma's pressure on the surrounding brain tissue can lead to ischemia and commonly cause a characteristic ring-shaped low density due to edema around the hematoma.

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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.

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Written by Chen Yu Fei
Neurosurgery
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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.

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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.