What are the early symptoms of cerebral hemorrhage?

Cerebral hemorrhage is a very common thing in life, and the incidence rate of cerebral hemorrhage has been getting higher and higher in recent years, and cerebral hemorrhage is becoming younger and younger. In fact, most of the time when cerebral hemorrhage occurs, there will be signs. Some people will experience numbness, weakness and other phenomena before the onset of cerebral hemorrhage, but these phenomena are often easily ignored. The following is a detailed introduction to the early symptoms of cerebral hemorrhage.

Cerebral hemorrhage refers to bleeding caused by non-traumatic rupture of blood vessels in the brain parenchyma, accounting for 20% to 30% of all strokes, with an acute mortality rate of 30% to 40%. The cause of the occurrence is mainly related to cerebrovascular lesions, that is, it is closely related to hyperlipidemia, diabetes, hypertension, vascular aging, smoking, etc. Patients with cerebral hemorrhage often suffer sudden onset of symptoms due to emotional excitement or strenuous effort. The early mortality rate is very high, and most survivors have sequelae such as movement disorders, cognitive disorders, speech and swallowing disorders to varying degrees.

Hypertensive cerebral hemorrhage often occurs in people aged 50 to 70 years old, slightly more often in men. It is more likely to occur in winter and spring, usually during activities and emotional excitement. There are usually no warning signs before bleeding. Half of the patients have severe headaches and vomiting is common. Blood pressure rises significantly after bleeding. Clinical symptoms often reach a peak within minutes to hours. Clinical symptoms and signs vary depending on the site and amount of bleeding. Mild hemiplegia caused by bleeding in the basal ganglia, thalamus and internal capsule is a common early symptom. A small number of cases have epileptic seizures, which are often focal. Severe cases quickly turn into confusion or coma.

1. Movement and language disorders

The most common movement disorder is hemiplegia; the most common speech disorder is aphasia and slurred speech.

2. Vomiting

About half of the patients experience vomiting, which may be related to increased intracranial pressure, vertigo, and irritation of the meninges by blood during cerebral hemorrhage.

3. Impairment of consciousness

It manifests as drowsiness or coma, the degree of which is related to the location, amount and speed of cerebral hemorrhage. Large amounts of bleeding in deep parts of the brain within a short period of time will most likely result in impaired consciousness.

4. Eye symptoms

Anisocoria often occurs in patients with increased intracranial pressure and brain herniation; hemianopsia and eye movement disorders may also occur. During the acute phase of cerebral hemorrhage, patients often stare at the bleeding side of the brain (gaze palsy).

5. Headache and dizziness

Headache is the first symptom of cerebral hemorrhage, often located on the side of the head with bleeding; when there is increased intracranial pressure, the pain can spread to the entire head. Dizziness often accompanies headache, especially when bleeding occurs in the cerebellum or brain stem.

Middle-aged and elderly patients who suddenly develop the disease during activities or when they are emotionally excited and quickly develop symptoms of focal neurological deficits and symptoms of intracranial hypertension such as headaches and vomiting should consider the possibility of cerebral hemorrhage. Combined with a head CT scan, a clear diagnosis can be made quickly. The diagnosis of cerebral hemorrhage is mainly based on:

1. Most of them are over 50 years old and have a long history of hypertension and arteriosclerosis.

2. Sudden onset of symptoms during physical activity or emotional excitement, with symptoms such as headache, vomiting, and impaired consciousness.

3. The onset is rapid, with symptoms of limb dysfunction and increased intracranial pressure appearing within minutes or hours.

4. Physical examination shows localized signs of the nervous system.

5. Brain CT scans can show that intracerebral hematomas are high-density areas, and can accurately show hematomas with a diameter of >1.5cm. It can determine the site of bleeding, the size of the hematoma, whether it has broken into the ventricle, and whether there is brain edema and brain herniation. The diagnosis is based on the bleeding lesions seen in the brain CT scan. CT can diagnose almost 100% of cerebral hemorrhage.

6. Lumbar puncture may reveal bloody cerebrospinal fluid. Currently, cerebral hemorrhage is rarely diagnosed based on cerebrospinal fluid.