hemorrhagic stroke
Introduction
Introduction to hemorrhagic stroke Hemorrhagic stroke generally refers to coma and convulsions caused by cerebral hemorrhage (cerebral hemorrhage), and is more common in hypertensive patients over 50 years old, with more men. According to the bleeding site, cerebral hemorrhage can be divided into internal capsule hemorrhage, bridge cerebral hemorrhage, cerebellar hemorrhage Symptoms of hemorrhagic stroke are vomiting, sudden coma, incontinence, fever, etc., but coma is the main symptom of hemorrhagic stroke. basic knowledge The proportion of illness: 0.003% Susceptible people: no specific people Mode of infection: non-infectious Complications: cerebral palsy, elderly patients with brain and heart syndrome, cerebrovascular disease, hemorrhoids, electrolyte imbalance
Cause
Hemorrhagic stroke
Qi deficiency and blood stasis (20%):
Work tired and hurt the spleen, or high and low body, eating disorders, qi and blood biochemical sources, qi and blood deficiency, lack of qi, bloodless, blood stasis, or blood stasis, with the pulse up, blocking the brain Network.
Impotence and blood stasis (20%):
The age is getting higher, the viscera is getting worse, the liver and kidney are yin, the liver is yang, or the person is flat, or the sexual intercourse is excessive, or the physical exertion is excessive, the liver and kidney yin, or the seven emotions, the liver loss Straight, qi stagnation, yin and yang disorders, liver yang sputum, or congenital inheritance, lack of endowment, hidden yin deficiency and impotence, plus carelessness after the day (including diet, emotional, fatigue, environment, etc.) , causing liver yang. In turn, the liver wind moves, the blood reverses with the wind, the blood stagnates in the brain, the blood stasis does not disperse, and the brain is blocked. This is one of the causes of hemorrhagic stroke.
brain (30%):
Inadvertent maintenance, frequent meals, excessive meat consumption, or alcoholism, phlegm and dampness, blood turbidity and blood thickening, gradually becoming blood stasis, or phlegm heat, phlegm heat, smoldering, blood It is also the cause of hemorrhagic stroke.
Liver and kidney yin deficiency blood is yin, if the liver and kidney yin deficiency, the blood is thick, or then block the brain.
Prevention
Hemorrhagic stroke prevention
1. The patient should be placed on his or her back, without placing a pillow or slightly raising the head and shoulders, so that the lower jaw is slightly raised. Untie the neckline button, tie, belt, bra, and remove if you have a denture.
2. The head is biased to one side to prevent sputum from sputum or vomit returning into the trachea.
3. If the patient is awake, pay attention to comfort the patient and relieve his nervousness.
4. If the patient's snoring is obvious, suggesting that the airway is blocked by the falling tongue root, the patient's lower jaw should be raised to make it into the upward position, and the patient's vomit can be wiped off at any time with a towel.
5. Call the emergency center or hospital neurology specialist for help.
6. Do not take the medicine to the patient without a doctor's diagnosis.
Complication
Hemorrhagic stroke complications Complications, cerebral palsy, brain and heart syndrome, cerebrovascular disease, acne, electrolyte disorder
1. Cerebral palsy, cerebrovascular disease.
2. Brain and heart syndrome.
3. Bladder and rectal dysfunction.
4. Renal failure and electrolyte imbalance.
5. Central thermoregulatory disorders.
6. Acne.
Symptom
Hemorrhagic stroke symptoms Common symptoms High fever, numbness, numbness, heart and brain, lack of blood supply, sinus, can't talk, irritability, shortness of breath, shortness of breath, coma
The symptoms of hemorrhagic stroke are:
1. Short-term headache, vomiting, partial weakness or/and numbness, skewed mouth, unclear speech, lethargy, irritability, and even unconsciousness, which is more serious in the symptoms of hemorrhagic stroke.
2, the symptoms of hemorrhagic stroke are also manifested in the early stage of the disease, more blood pressure, rapid heart rate, shortness of breath, varying degrees of disturbance of consciousness.
3, fundus examination can be seen retinal arteriosclerosis, retinal hemorrhage, occasionally papilledema.
4. Most patients with hemorrhagic stroke have positive meningeal irritation.
5, limb hemiplegia, partial sensory disturbance, same-direction hemianopia. Large amounts of bleeding or bleeding near the thalamus often have high fever, small pupils, coma and sputum returning.
6, cerebral hemorrhage: cross-sectional sputum, that is, hemorrhagic lateral nerve and abducens nerve paralysis, contralateral limb paralysis; cross-sensory disturbance, that is, the side of the source of sensory disturbance and sensory disturbance of the contralateral limb, both eyes gaze to the affected side; Severe cases of double pupil diminished, coma, tonic or quadriplegia, high fever, central dyspnea and so on.
7, cerebellar hemorrhage: more manifestations of dizziness, frequent vomiting, nystagmus, ataxia, intentional tremor, widening of the base of the walking. A person with a large amount of bleeding can present a sudden coma and a large hole in the occipital bone.
8, ventricular hemorrhage: severe cases of coma, double pupil diminished, central high fever.
In addition, the symptoms of hemorrhagic stroke are vomiting, sudden coma, incontinence, fever, etc., but coma is the main symptom of hemorrhagic stroke.
Examine
Hemorrhagic stroke
1. Cerebrospinal fluid examination. Examination of cerebrospinal fluid. The cerebrospinal fluid pressure measured after puncture was 0.78-1.96 kPa (80-200 mm water column) for the adult in the lateral position, 0.39-0.98 kPa (40-100 mm water column) for the infant, and 0.098-0.14 kPa for the newborn (10- 14mm water column). When observing the initial pressure, attention should be paid to the presence or absence of respiratory pulsation in the cerebrospinal fluid level (with a respiratory rate of 0.098-0.197 kPa (10-20 mm water column pulsation) and pulse pulsation (with a pulse of 0.02-0.039 kPa (2-4 mm water column). Liquid level pulsation). When the former disappears, it indicates that there is obstruction in the spinal canal or there is a large hole in the occipital cavity.
2. Head CT examination. CT examination of the brain is a method of examining the brain by CT. Head CT is a convenient, rapid, safe, painless, non-invasive new examination method that clearly shows the anatomical relationship of different cross sections of the brain and the specific brain tissue structure. Therefore, the detection rate of the lesion and the accuracy of the diagnosis are greatly improved. In general, CT is better for soft tissue imaging than for soft tissue. Head CT examination is important for the diagnosis of most diseases of the brain, skull, and scalp (including trauma, tumor, inflammation, vascular disease, poisoning, degeneration, and metabolic diseases).
3. Cerebral angiography.
4. Brain B-ultrasound examination.
5. EEG.
Diagnosis
Diagnosis and diagnosis of hemorrhagic stroke
diagnosis
Diagnosis can be performed based on clinical manifestations and examinations.
Differential diagnosis
The disease is differentiated from cerebral hemorrhage, subarachnoid hemorrhage, cerebral thrombosis, cerebral embolism and transient ischemic attack.
Cerebral hemorrhage: The age of ICH is 50 to 70 years old. Men are slightly more than women, with a high incidence in winter and spring, with a history. More sudden onset in emotional or active activities. After the onset of the disease, the condition often peaks within a few minutes to several hours.
Cerebral embolism: acute onset is the main feature, and it is one of the most urgent diseases. Most patients have no prodromal symptoms before the disease, and suddenly start the disease during activity. Most of the symptoms develop to the highest peak in a few seconds or minutes. A small number of patients have a step or progressive deterioration within a few days, and about half of the patients have a disturbance of consciousness at the onset, but the duration is short. Most of the cerebral embolism occurs in the internal carotid artery system, especially the middle cerebral artery. The neurological dysfunction caused by embolization depends on the number, extent and location of the embolism. There may be headache, dizziness or localized pain during acute onset.
