How to care for cerebral hemorrhage

Written by Zhang Hui
Neurology
Updated on March 14, 2025
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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 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.

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Written by Gao Yi Shen
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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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Written by Liu Yan Hao
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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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Written by Zhang Hui
Neurology
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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.

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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.