hypertensive intracerebral hemorrhage
Introduction
Introduction to Hypertensive Cerebral Hemorrhage Hypertensive cerebral hemorrhage refers to rupture of the small arteries in the brain due to long-term hypertension and cerebral arteriosclerosis due to pathological changes. Among the causes of various non-injury cerebral hemorrhage, hypertension accounts for about 60%. It is one of the most serious complications of hypertension. It is more common in patients aged 50-60 years, and the incidence rate of males is slightly higher than that of females. basic knowledge The proportion of illness: 0.006% Susceptible people: more common in the elderly Mode of infection: non-infectious Complications: hemiplegia
Cause
Causes of hypertensive intracerebral hemorrhage
The cause of hypertensive cerebral hemorrhage usually occurs during activity and agitation.
Most scholars believe that long-term hypertension can cause hyaline degeneration of the cerebral arteries, first swelling the subendocardial matrix, lipid precipitation under the intima, forming a non-structural substance between the inner membrane and the inner elastic layer, and reducing the elasticity. , brittleness increases. Loss of vascular wall tension and fibrinous necrosis, resulting in local arteries under the impact of blood pressure in the spindle or spherical protrusion, that is, miliary aneurysm, blood can also invade the wall to form a dissection aneurysm. When the blood pressure suddenly rises, the aneurysm rupture causes bleeding. In addition, high blood pressure can also cause cerebral arteriolar spasm, leading to ischemia, hypoxia, necrosis and bleeding in the distal brain tissue. In addition, the inner wall of the brain is weak, the connective tissue of the middle muscle cells and the outer membrane is small, and there is no external elastic layer, which may lead to hypertensive cerebral hemorrhage more than other visceral hemorrhage.
Prevention
Hypertensive cerebral hemorrhage prevention
To prevent this disease, keep the following in mind:
1. Early detection of hypertension and timely treatment of high blood pressure, regular checkups, should be adhered to medication after diagnosis.
2. Flirting emotions: optimistic mood, reducing troubles, sorrows and sorrows, indifferent to fame and fortune, contentment and happiness.
3. Smoking and alcohol: Both wine and tobacco can cause vasoconstriction, rapid heartbeat, blood pressure rise, accelerate arteriosclerosis, coronary heart disease, and patients with hypertension should quit smoking and alcohol.
4. Choose diet: Eat low-fat, low-salt, low-sugar, eat less animal brain, internal organs, eat more vegetables, fruits, soy products, with appropriate amount of lean meat, fish, eggs.
5. Avoid fatigue: avoid physical and mental labor, excessive work can induce cerebral hemorrhage.
6. Anti-constipation: dry stool, defecation force, easily break the fragile small blood vessels and cause cerebral hemorrhage, prevent constipation, eat more fiber-rich foods, such as vegetables, celery, leeks and fruits, etc. Exercise and self-massage of the abdomen before getting up in the morning.
7. Do not squat: When the squatting, the lower extremity blood vessels will be severely flexed, and if the bowel movements are defecation and the intra-abdominal pressure is increased, the blood pressure can be increased, and a cerebrovascular accident may occur, and the sitting will not cause an increase in blood pressure. It can reduce the chance of a stroke.
8. Anti-fall: The elderly have more cerebral arteriosclerosis, the blood vessel wall is more fragile, and the risk of intracranial blood vessel rupture occurs after falling. Therefore, be careful when taking action.
9. Left-handed: Use the left upper limb and the left lower limb more frequently, especially with the left hand, which can reduce the burden on the left hemisphere of the brain and exercise the right hemisphere of the brain. Medical research shows that cerebral hemorrhage is most likely to occur in the right hemisphere with weak blood vessels, so The best way to prevent the occurrence of cerebral hemorrhage is to turn two fitness balls with your left hand in the morning and evening to help the function of the right hemisphere play normally.
Complication
Hypertensive cerebral hemorrhage Complications
Due to different bleeding sites and bleeding volume, complications are different, and hemiplegia is common.
Symptom
Symptoms of hypertensive cerebral hemorrhage Common symptoms Hypertrophic brain cells appear nutrition... Consciousness of consciousness disorder Increased intracranial pressure Hypothalamic hemorrhage Dehydration Thalamic hemorrhage Cerebral hemorrhage Deep coma
1. Sudden headache or dizziness, accompanied by vomiting.
2. Many are accompanied by different levels of disturbance of consciousness.
3. There are varying degrees of hemiplegia and even aphasia.
4. Incontinence.
5. If the amount of bleeding is large and the brain stem is involved, there may be symptoms such as large pupils, slow breathing, and strong brain.
6. Blood pressure at onset is significantly higher than usual blood pressure.
7. The above symptoms and signs can develop to a peak within a few hours.
Examine
Hypertensive cerebral hemorrhage
1. Cerebral hemisphere hypertensive cerebral hemorrhage, CT scan of the brain can be diagnosed.
2. Cerebellar hypertensive cerebral hemorrhage or brain stem hemorrhage, feasible head CT or MRI, the latter is better than the former.
3. Those who need surgery to remove hematoma should perform basic examination.
4. If necessary, perform cerebral angiography to rule out cerebral vascular malformations or aneurysms.
5. Evoked potential can determine the presence or absence of secondary brain stem damage, SPECT can help to understand the function of the local brain.
Diagnosis
Diagnosis and diagnosis of hypertensive intracerebral hemo
diagnosis
1. Middle-aged or older, with a history of hypertension, and more often when active (such as agitation, exertion) onset.
2. Often with sudden headache, dizziness as the first symptom, followed by vomiting, convulsions, disturbance of consciousness, convulsions, urinary incontinence and so on.
3. The neck is stiff, the blood pressure is increased, the pulse rate is slow, the breathing is deep and slow, with a voice, and there may be symptoms of respiratory failure in the later stage.
4. Different bleeding sites may have different signs of nerve damage.
5. Cerebrospinal fluid pressure increased, containing red blood cells, protein quantitative increase.
6. Cerebral angiography showing signs of space-occupying lesions.
7. CT scan or MRI: shows the location, extent, amount of bleeding, cerebral edema around the hemorrhage and variability of the ventricle under pressure.
Differential diagnosis
1, coma patients should be differentiated from dysfunction caused by carbon monoxide poisoning, hepatic coma, uremia, hypoglycemia, etc., mainly in detail about medical history, signs and CT, cerebrospinal fluid and other tests.
2, intracranial lesions, craniocerebral trauma, meningitis and other diseases: according to the severity of the disease, history of trauma, fever and other clinical manifestations as well as CT, MRI, cerebrospinal fluid and other tests to make a diagnosis.
3, and other cerebrovascular diseases such as cerebral infarction, subarachnoid hemorrhage, according to the pathogenesis, symptoms, signs and imaging examination confirmed.
