What is Cerebral Hemorrhage

What Is Cerebral Hemorrhage?

Cerebral hemorrhage refers to the bleeding caused by non-traumatic vascular rupture in brain parenchyma. It accounts for 20% to 30% of all strokes, and the mortality in acute stage is 30% to 40%.

It is mainly related to cerebrovascular diseases including hyperlipidemia, diabetes, hypertension, vascular aging, smoking and so on. Patients with cerebral hemorrhage often have sudden onset due to emotional excitement and excessive force, and the mortality in early stage is very high. In addition, most survivors have motor dysfunction, cognitive impairment, speech and swallowing disorders and other sequelae.

What Is the Etiology of Cerebral Hemorrhage?

Common causes are hypertension with arteriosclerosis, microangioma or microangioma. Others include cerebrovascular malformation, meningeal arteriovenous malformation, amyloid cerebrovascular disease, cystic hemangioma, intracranial venous thrombosis, specific arteritis, Fungal arteritis, moyamoya disease and arterial anatomical variation, vasculitis, tumor stroke, etc.

There are also other causes like blood factors including anticoagulation, antiplatelet or thrombolytic therapy, Haemophilus infection, leukemia, thrombocytopenia intracranial tumors, alcoholism and sympathetic drugs.
In addition, excessive force, climate change, unhealthy hobbies (smoking, alcoholism, salty diet, overweight), blood pressure fluctuation, emotional agitation, overwork, etc. could also be the induced factors of cerebral hemorrhage.

What Are the Symptoms of Cerebral Hemorrhage?

Hypertensive intracerebral hemorrhage usually occurs in the ages of 50 to 70, and more in male. It is easy to occur in winter and spring, and it usually occurs during activities and emotional excitement. There is usually no warning before the bleeding and almost half of the patients would have severe headache as well as vomit. Blood pressure rises significantly after the hemorrhage and the clinical symptoms usually reach to a peak in minutes or hours. The clinical symptoms and signs vary according to the location and the amount of bleeding. Hemiplegia caused by hemorrhage in the basal nucleus, thalamus and internal capsule is a common early symptom. There could also be a few cases of epilepsy that are usually focal. And severe patients would quickly turn into unconsciousness or coma.

1. Motor and speech dysfunction
Motor dysfunction usually refers to hemiplegia and speech dysfunction are mainly aphasia and ambiguity.
2. Vomiting
Almost half of the patients would have vomiting, and this could be related to increased intracranial pressure during cerebral hemorrhage, vertigo attacks, and blood stimulation of the meninges.
3. Consciousness Disorder
Lethargy or coma, and the degree is related to the location, volume, and speed of bleeding. A large amount of bleeding in a short period of time in the deep part of the brain is more likely to cause unconsciousness.
4. Eye symptoms
Unequal pupil size usually occurs in patients with cerebral hernia due to increased intracranial pressure; there may also be hemianopia and impaired eye movement. Patients with cerebral hemorrhage often gaze at the hemorrhage side of the brain in the acute phase (gaze paralysis).
5. Headache and dizziness
Headache is the first symptom of cerebral hemorrhage, and it is often on the bleeding side. When intracranial pressure increases, the pain can develop to the whole head. Dizziness is often associated with headaches, especially in cerebellum and brainstem hemorrhage.