Is cerebral hemorrhage dangerous?

Written by Tang Li Li
Neurology
Updated on September 24, 2024
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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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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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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.

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What are the symptoms of cerebral hemorrhage?

For patients with cerebral hemorrhage, the symptoms vary clinically due to different amounts of bleeding and instability of the hemorrhage, which affect the surrounding brain tissue to different extents. For patients with minor cerebral hemorrhage, the impact is generally minor, and most patients only exhibit mild symptoms such as headache, dizziness, nausea, and retching. For patients with larger bleeding volumes located in crucial motor and speech functional areas, they often show symptoms such as unilateral limb paralysis and abnormal sensations in the affected limbs, accompanied by significant headaches, dizziness, reduced intellectual levels, cognitive impairments, and even aphasia.

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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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How to treat cerebral hemorrhage?

Cerebral hemorrhage is a dangerous disease. Once diagnosed with cerebral hemorrhage, the patient's treatment plan mainly requires strict bed rest and maintaining a calm emotional state to avoid emotional excitement and fluctuations in blood pressure. If the patient develops acute ulcers, it is crucial to pay attention to treatments that protect the gastric mucosa. Additionally, if the patient suffers from severe headaches, an appropriate amount of painkiller may be administered. If there is a significant increase in intracranial pressure, dehydration and reduction of intracranial pressure should be considered. Managing blood pressure is also very important in treating cerebral hemorrhage; it is essential to keep the blood pressure stable. If the hemorrhage is caused by abnormalities in clotting functions, intravenous coagulation medications may be administered. Furthermore, if the volume of cerebral hemorrhage is large and threatens the patient's life, with a tendency for brain herniation, neurosurgery may be required to remove the hematoma and save the patient's life.