Popular Science | Learn about cerebral hemorrhage and rehabilitation

What is a brain hemorrhage?

Cerebral hemorrhage, also known as spontaneous cerebral hemorrhage, is a disease in which blood vessels in the brain rupture, causing blood to flow out of the blood vessels. It accounts for 20% to 30% of acute cerebrovascular diseases and has a high mortality rate.

Depending on the location of bleeding, cerebral hemorrhage can be divided into basal ganglia hemorrhage, thalamic hemorrhage, lobar hemorrhage, brainstem hemorrhage, cerebellar hemorrhage and intraventricular hemorrhage.

Cerebral hemorrhage is mainly caused by ruptured blood vessels due to high blood pressure and arteriosclerosis. In addition, some unhealthy lifestyles, such as being overweight, drinking, smoking, and using cocaine, can also increase the risk of cerebral hemorrhage.

What are the symptoms after a cerebral hemorrhage?

Cerebral hemorrhage usually occurs suddenly, and early symptoms include headache, dizziness, limb weakness, vomiting, etc. The clinical manifestations of cerebral hemorrhage in different parts and degrees are also different. Patients with bleeding in certain specific parts may have typical symptoms such as slurred speech, facial numbness, visual impairment, hemiplegia, and difficulty walking. Patients with large amounts of bleeding and severe conditions may show varying degrees of impaired consciousness, which may progress rapidly within minutes or hours and even be life-threatening.

What is the prognosis of cerebral hemorrhage?

The prognosis of cerebral hemorrhage is affected by many factors, including the location of bleeding, the amount of bleeding, the speed of bleeding, and the post-bleeding treatment measures. Some patients can resume normal life after treatment, but some patients will have long-term functional disorders such as paralysis, speech, cognition, and swallowing, which will affect their daily living activities and quality of life.

How to recover after a cerebral hemorrhage?

Under the premise of not affecting rescue and treatment, rehabilitation treatment should be started as soon as possible after cerebral hemorrhage, mainly including early posture management (Figures 1-3), joint range of motion maintenance training, muscle massage, etc., to prevent and treat complications such as shoulder subluxation, joint contracture, muscle atrophy, and pressure sores.

When the condition stabilizes, the content of rehabilitation treatment gradually increases, including: turning over training (Figure 4), exercise training of the affected limb (Figure 5), lying-sitting transfer (Figure 6), sitting training (Figure 7), sitting-standing transfer training (Figure 8), standing training (Figure 9), walking training (Figure 10), etc. Some patients need to be equipped with wheelchairs or canes, etc. At the same time, daily living activities training should be carried out according to the specific conditions of the patients, such as washing, dressing, eating, going to the toilet, etc.

Six months to one year after a cerebral hemorrhage, the patient's functional recovery gradually slows down. At this time, the focus of rehabilitation treatment is to strengthen the use of residual functions and make suggestions for the modification of the family environment according to the patient's needs. For example, remove the threshold, add handrails in front of the bathtub, change the squat toilet to a sit-down toilet, etc.

How to prevent cerebral hemorrhage? The most important thing to prevent cerebral hemorrhage is to reduce risk factors, such as controlling high blood pressure and high blood sugar, changing unhealthy lifestyles, and doing regular physical examinations. Please remember:

References

[1] Liu Zhipeng, Guo Mingen. Effect of early physical therapy on the prognosis of patients with acute stroke and hemiplegia[J]. Medical Frontier, 2024, 14(31): 65-67.

[2] Zhao Bin. How to prevent cerebral hemorrhage in patients with hypertension[J]. Everyone's Health, 2024, (15): 27.

END Author: Li Biao (Shanghai Hebin Rehabilitation Hospital)

Reviewer: He Longwen (Shanghai Hebin Rehabilitation Hospital, member of the Cognitive Rehabilitation Committee of the Chinese Rehabilitation Medicine Association)

Yan Yanning (Hebei Provincial People's Hospital, Vice Chairman of the Science Popularization Working Committee of the Chinese Rehabilitation Medicine Association)