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 recover from cerebral hemorrhage

The recovery from cerebral hemorrhage is divided into the acute phase and the non-acute phase. In the acute phase, if there is a large amount of bleeding and increased intracranial pressure, surgical intervention can be considered. If the bleeding is less but intracranial pressure is still high, general treatment includes managing blood pressure well, maintaining it at 140 systolic pressure, under which conditions things generally tend to be better. Additionally, controlling intracranial pressure and treatment to stop the bleeding are needed. Later stages involve anticoagulant reversal treatments and prevention of complications because infections, high blood sugar, and stress ulcers can further worsen the condition. The later stages primarily focus on rehabilitation training treatments, helping with limb and speech rehabilitation training.

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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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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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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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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.