Acute and subacute intracerebral hematoma
Introduction
Introduction to acute and subacute intracerebral hematoma Acute and subacute intracerebral hematoma is a traumatic intracerebral hematoma, most of which are acute, and a few are subacute, especially in the superficial intracerebral hematoma located in the frontal, temporal and anterior portions, often with brain contusion and laceration. Subdural hematoma is accompanied by clinical manifestations. Deep hematoma, more than the white matter of the brain, caused by deep deformation of the blood vessels due to deformation or shearing force of the brain, less bleeding, less hematoma, clinical manifestations are also slower. When the hematoma is large, the hematoma located near the basal ganglia, thalamus or ventricular wall of the brain can cause intraventricular hemorrhage to the ventricular rupture. The condition is often severe and the prognosis is poor. basic knowledge The proportion of sickness: 0.01% Susceptible people: no specific population Mode of infection: non-infectious Complications: brain contusion, subdural hematoma
Cause
Acute and subacute intracerebral hematoma etiology
Cause:
Traumatic intracerebral hematoma occurs in the frontal and temporal lobes, accounting for about 80% of the total, often caused by contusive brain contusion, followed by parietal and occipital lobe, accounting for about 10%. Caused by impact injury or depression fracture, the rest are deep brain, brain stem and cerebellum, etc., the brain hematoma, a small number.
Prevention
Acute and subacute intracerebral hematoma prevention
The disease is a traumatic disease, no preventive measures, pay attention to safety, avoid trauma, once the brain trauma should be diagnosed as early as possible, early treatment.
Complication
Acute and subacute intracerebral hematoma complications Complications, brain contusion, subdural hematoma
1. Shallow intracerebral hematoma located in the frontal, anterior temporal and base of the tibia, often associated with brain contusion and subdural hematoma.
2. Secondary brain swelling and cerebral edema.
3. Severe patients are prone to upper gastrointestinal bleeding, and appropriate measures should be taken to prevent them.
4. Long-term coma patients are prone to pulmonary infection, water and electrolyte balance disorders, hypothalamic dysfunction, malnutrition, hemorrhoids, etc., while strengthening nursing measures, should be dealt with in a timely manner.
Symptom
Symptoms of acute and subacute intracerebral hematoma common symptoms hemianopia sensory disturbance consciousness headache headache and vomiting cerebral palsy increased intracranial pressure
1. The vast majority of traumatic intracerebral hematoma is acute, and a few are subacute.
2. The clinical manifestations of intracerebral hematoma, depending on the location of the hematoma, the hematoma at the front and bottom of the forehead, sputum and the contusive brain contusion, subdural hematoma, except for increased intracranial pressure, no significant localization Symptoms or signs, if the hematoma involves important functional areas, hemiplegia, aphasia, hemianopia, partial sensory disturbance and focal epilepsy may occur. Patients with intracerebral hematoma due to hemispheric contusion and laceration, post-injury disturbance More persistent, and progressively aggravated, more without intermediate consciousness improvement period, rapid changes in disease, prone to cerebral palsy, local hematoma caused by impact injury or sag fracture, slower development of the disease, in addition to local brain function In addition to the symptoms of damage, there are often signs of increased intracranial pressure such as headache, vomiting, fundus edema, especially in the elderly due to increased vascular fragility, more likely to occur intracerebral hematoma.
Examine
Examination of acute and subacute intracerebral hematoma
CT scan or cerebral angiography, in the case of emergency, according to the analysis of the injury mechanism or the use of brain ultrasound to determine the side, as early as possible in the ankle or suspicious part of the hole exploration, parallel frontal and temporal lobe puncture, so as not to miss the intracerebral hematoma Because this type of hematoma is mostly a complex hematoma, and often multiple, it is very important to determine the location of the hematoma and imaging examination according to the injury mechanism analysis. Otherwise, it is easy to miss the hematoma during the operation, it should be noted that the acute phase More than 90% of intracerebral hematoma can show high-density mass on CT scan, surrounded by low-density edema, but the hematoma becomes equal density at 2 to 4 weeks, easy to miss diagnosis, and low density when it is more than 4 weeks. In addition, late onset intracerebral hematoma is more common in patients with delayed hematoma, should be vigilant, if necessary, should be a CT review.
Diagnosis
Diagnosis and diagnosis of acute and subacute intracerebral hematoma
diagnosis
Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.
Differential diagnosis
1. Cerebral hemorrhage: no clear history of trauma, history of hypertension, no brain contusion, skull fracture, scalp injury and other manifestations.
2. Epidural hematoma and subdural hematoma, CT examination can be found under the skull inside the skull, it is not difficult to identify.
