How much do you know about hypertensive cerebral hemorrhage?

Author: Zhang Xiaojue Lanling Hospital Affiliated to Qilu Medical College

Reviewer: Wei Xiuchuan, deputy chief physician of Lanling Hospital affiliated to Qilu Medical College

In the fast-paced modern life, hypertension is a common chronic disease, and its potential risks are often overlooked. When hypertension is not effectively controlled, it may cause a series of serious complications, among which hypertensive cerebral hemorrhage is the most urgent and dangerous one.

1. Basic Concepts of Hypertensive Cerebral Hemorrhage

1. Definition and etiology

Hypertensive cerebral hemorrhage refers to a serious disease caused by long-term hypertension that leads to lesions in the small arteries in the brain, which eventually rupture and bleed, causing brain dysfunction. Hypertension is the most important independent risk factor for cerebral hemorrhage. The sclerosis of the blood vessel walls, weakened elasticity and formation of microaneurysms caused by hypertension are the direct pathological basis of cerebral hemorrhage.

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2. Pathogenesis

The pathogenesis of hypertensive cerebral hemorrhage is complex, mainly including vascular wall lesions, hemodynamic changes and abnormal blood components. Long-term hypertension causes excessive pressure on brain blood vessels, and the blood vessel walls gradually thicken and harden, forming microaneurysms. When blood pressure suddenly rises, these fragile blood vessel walls cannot withstand the pressure and rupture, causing blood to flow into the brain tissue, forming a hematoma, compressing the surrounding brain tissue, and causing brain dysfunction.

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2. Clinical manifestations of hypertensive cerebral hemorrhage

1. Typical symptoms

Symptoms of hypertensive cerebral hemorrhage are usually severe and sudden, mainly including:

Severe headache: often manifested as unbearable persistent headache.

Impairment of consciousness: Mild cases may present with drowsiness and coma, while severe cases may present with deep coma.

Limb movement disorders: weakness, numbness or paralysis of one side of the limbs, etc.

Language disorders: slurred speech, aphasia, or inability to understand what others are saying.

Eye symptoms: unequal pupil size, weakened or absent light reflex, etc.

Others: nausea, vomiting, restlessness, etc.

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2. Seek emergency medical attention

Hypertensive cerebral hemorrhage is an acute cerebrovascular disease that progresses rapidly and has a very limited treatment window. Therefore, once the above symptoms occur, you should call the emergency number immediately and send the patient to a qualified hospital for emergency treatment.

Treatment of Hypertensive Cerebral Hemorrhage

1. Conservative treatment

For patients with less bleeding and milder symptoms, conservative treatment measures can be taken, including:

Control blood pressure: Use medication to quickly lower blood pressure to a safe range to prevent further bleeding.

Reduce intracranial pressure: Use dehydrating agents, diuretics, etc. to reduce cerebral edema and reduce intracranial pressure.

Procoagulants: promote hematoma absorption and reduce the pressure of hematoma on brain tissue.

Nutritional support: Maintain water and electrolyte balance and provide necessary nutritional support.

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2. Surgery

For patients with heavy bleeding and critical condition, surgical treatment should be performed promptly, including:

Craniotomy and hematoma evacuation: Directly remove the intracerebral hematoma through surgery to relieve brain tissue pressure.

Ventricular drainage: For patients with ventricular hemorrhage, ventricular drainage can be performed to reduce intracranial pressure.

Decompressive craniectomy: For patients with severe cerebral edema and difficult-to-control intracranial pressure, decompressive craniectomy can be performed to relieve intracranial hypertension.

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4. Prevention of Hypertensive Cerebral Hemorrhage

1. Control blood pressure

The key to preventing hypertensive cerebral hemorrhage is to effectively control blood pressure. Hypertensive patients should take antihypertensive drugs regularly as prescribed by their doctors, monitor blood pressure changes regularly, and ensure that blood pressure is controlled within the ideal range.

2. Healthy Lifestyle

Reasonable diet: low-salt, low-fat, high-fiber diet, reduce salt and fat intake, and eat more fresh vegetables and fruits.

Moderate exercise: Choose appropriate exercise according to your own situation, such as walking, jogging, swimming, etc., to enhance cardiopulmonary function.

Quit smoking and limit alcohol consumption: Both smoking and excessive drinking will increase the risk of hypertensive cerebral hemorrhage. You should quit smoking and limit alcohol consumption as soon as possible.

Maintain a healthy weight: Avoid obesity and overweight, and maintain a healthy weight range through a proper diet and moderate exercise.

3. Regular physical examinations

Patients with hypertension should undergo regular physical examinations, including testing of indicators such as blood pressure, blood lipids, and blood sugar, as well as imaging examinations such as electrocardiogram, brain CT or MRI, in order to promptly detect and treat potential cerebrovascular diseases.

4. Psychological adjustment

Maintaining a good mentality and emotional stability is also important for preventing hypertensive cerebral hemorrhage. Avoid long-term mental stress, anxiety or depression and other negative emotions, and perform appropriate psychological adjustments and relaxation training.

Hypertensive cerebral hemorrhage is a serious and urgent cerebrovascular disease, and its occurrence is closely related to the control of hypertension. By understanding the basic knowledge of hypertensive cerebral hemorrhage, identifying its typical symptoms, mastering the correct treatment methods and taking effective preventive measures, the morbidity and mortality of hypertensive cerebral hemorrhage can be significantly reduced.