Cerebral hemorrhage


Cerebral hemorrhage

Description cerebral hemorrhage

The brain leads a rich vascular supply. The two main arteries – the carotid artery – resign from the aorta, the blood vessels going straight from the heart. Along the cervical spine also go two vessels that the level of the first vertebra entering into the cranial cavity. This ensures that most supply of oxygenated blood to the brain which is very sensitive. As a control center for the whole body has increased demands for nutrition and oxygen supply, so any deficiency is immediately reflected in the reduction or even arrest some functions.

The brain is coated by three different layers of tissues forming brain packaging. They surround both the brain and spinal cord and are designed to protect both institutions. Brain snug pia mater and accurately reproduces all the threads and indentations. Above it is Snowflies, a thin membrane that creates space for circulation and absorption of cerebrospinal fluid. The outer layer is solid dura mater, which separates the inner layer of the cerebral hemispheres, and separates the occipital lobe of the cerebellum. These three packages creates anatomical spaces between which may accumulate blood. Bleeding may occur in the brain tissue, then talk about the so-called. Splintery bleeding.

The source of the bleeding can be a cerebral artery or cerebral veins. Venous or arterial bleeding type is characteristic of the species and sometimes brain localization krvácení.Krvácení can beprimary, when the blood vessel in the brain bursts under the influence of e.g. high blood pressure, or secondary, in which bleeding is the result of various head injuries.

Risk factors for cerebral hemorrhage

With cerebral hemorrhage seen in accidents with intentional crimes, while unfortunate coincidences, in various diseases and increase the risk of bleeding as well as drinking, smoking, high blood pressure and certain medications.

Prevention of brain hemorrhage

For cerebral aneurysms none, they are innate. In general keep blood pressure normal, do not smoke, do not drink and do not expose to stress. It is also important to protect your skull in some occupations and in certain sports.

Symptoms of cerebral hemorrhage

The symptoms are varied, and varied according to the localization in brain, the amount of blood spillage and exposure time. For the diagnosis of cerebral hemorrhage, it is important to check the presumption on CT or magnetic resonance imaging, because the same symptoms as bleeding can cause “stroke”, a condition in which a catheter becomes clogged and forming a bearing nezásobené oxygen occurs ischemic stroke . It is therefore necessary to distinguish the cause of the symptoms, since whichever is selected treatment. Yet it should be noted that the so-called stroke is 80% of the ischemic nature, therefore it is clogged inlet vessel, and 20% is bleeding. It’s a name that does not distinguish cause, but covers clinical symptoms that are similar to identical.

Intracranial hemorrhage is divided according to the places where blood is spilled.

Epidural hemorrhage occurs in the space between the cranial bones and dura mater. It is usually associated with trauma and rupture of one branch of the carotid arteries. From spilled blood for several days formed blood clot or hematoma that oppresses brain. Usually localized at the site of impact or at the site of skull fractures. Hematoma pressing on the brain tissue, comes with altered consciousness and limb movement disorders, sometimes speech disorders. Hematoma is also bearing irritation that can also provoke epileptic seizures.

Subdural bleeding between the dura mater heads and Snowflies is again the result of a trauma and the source of the bleeding veins on the upper part of the cerebral hemispheres. The result is again a hematoma, which if clinically apparent between 24-48 hours is referred to as acute, can heal or go into chronic subdural hematoma, which is manifested by symptoms after three weeks since the accident, and it is slowly growing and expanding department , which occurs primarily in the elderly or individuals with an increased predisposition to bleeding. A typical group are chronic alcoholics.Injury is not as difficult times as a patient even remembers that something happened to him.

Acute hematoma is associated with brain contusion, especially in severe head injury. Dangerous are the hematomas, which axpanzivně increase for the oppression and degradation of the brain’s functions. It comes with disorders of consciousness, paralysis of limbs, and the pupils are unequally large.

Chronic hematoma is encapsulated and slowly grows month in the foreground is primarily psychological changes from mild depression to states of confusion, patients usually indicate headaches and dizziness.

As subarachnoid haemorrhage indicates the presence of blood between Snowflies and pia mater, the source is often rupture arterial aneurysm with untreated hypertension. This type is often associated with the richest symptomology, which substrate is increased intracranial pressure, bleeding irritating cerebral vessels which diminish its lumen and supplying a smaller amount of oxygen into the tissue. The patient has a headache, is confused, vomits, loses consciousness and comes on heart rhythm disorders.

Intracerebral bleeding, or bleeding in the brain tissue, it is massive and extensive, usually caused by rupture of a blood vessel with high blood pressure or after severe fractures of bones of the head associated with the tearing of brain tissue. If bleeding is massive cluster is associated tissue damage, impaired consciousness, vomiting, and headache, brain swelling and intracranial high pressure. Minor bleeding usually do not have a tissue destructive nature, consciousness is not violated, and is dominated by signs bearing, a paralysis of limbs, paralysis of the facial muscles and eye muscles, speech disorders. Bearing has an irregular shape, the surrounding tissue is compressed and bruising, accompanying findings are increased intracranial pressure and brain swelling. The mortality rate ranges between 30% – 40%, first 80-90% of patients dying. The decrease was primarily due to imaging methods to locate the bearing and allows faster and more accurate intervention. Survival of course also dependent on many factors such as the size of the bearing, on the extent of bleeding, the patient’s age and the condition of his consciousness. If bleeding is very large, it can compromise the well into cerebral ventricles, the cerebrospinal fluid is then stained with blood. The bleeding into the ventricles seen in premature neonates, as a complication of extensive subarachnoid hemorrhage coming in about 25%.

Treatment of brain hemorrhage

Diagnosis of epidural hematoma help already radiograph, CT bring clarification. It is the need for immediate surgical treatment, without timely launch hematoma occurs in such an increase in intracranial pressure and oppression of the brain and death. Treatment expansively growing subdural hematoma is also an acute surgical and also immediate.

Chronic hematoma again removed surgically and has excellent operating results, is to remedy the patient’s condition.

Treatment of intracerebral hemorrhage is aimed at supporting breathing and heart activity, to reduce brain swelling and intracranial hypertension. Should not be given blood thinning medication, the bleeding would only deepen. Waiting until the bleeding stops by itself, creates a hematoma and he absorbed over time. It is a question of months, meanwhile the patient as soon as possible to begin rehabilitation and according to a precise plan rehabilatačního. The surgical management of bleeding is applied only in very specific cases.

In subarachnoid hemorrhage in acute treatment is absolute bed rest, adjusting for high blood pressure, combat headaches and vomiting. The presumption aneurysm doctors confirm displaying the cerebral vasculature using contrast agents. When the patient’s condition stabilizes, approaches to surgical treatment, ideally within 48 hours from the beginning of the problems. For the treatment of cerebral aneurysms are used two techniques: operating a so-called. Endovascular. The basic difference is that the surgical treatment solves bulge externally artery, endovascular inside. Surgical treatment involves opening the skull surgery, endovascular surgery requires under X-rays.

It is worth remembering that not all aneurysms can be treated immediately after diagnosis, and that not all aneurysms are treatable by both methods. It is always necessary to consult a medical procedure with a specialist (neurosurgeon or neuroradiologi-) who will decide on the appropriate treatment and that individual patient. Hematoma, or bleeding site must be removed as soon as possible, because they threaten the patient to both life and devastate mechanical compression of previously healthy tissue, so it could happen that after a late cure would be the final extent of the disability greater than if the treatment acceded immediately .

How do I help myself

The most important thing is to think at all possible bleeding. Therefore, any injury or condition associated with a fall or blow to the head, as well as the sudden loss of consciousness, from which the patient for a long time does not discuss, it is necessary not to leave unnoticed and would prefer to call the PLA that the patient accepts the surgery or neurological ambulanici. Any oversights or underestimation of symptoms is very dangerous, because all cerebral hemorrhage threaten the patient’s life and most of them ending in death.

Complications of cerebral hemorrhage

Complications are multiple neurological manifestations corresponding location of bleeding in the brain. In the foreground is a change of consciousness from confusion to coma, as well as partial (paresis) or complete (plegia) paralysis of facial muscles, torso and limbs, or loss of momentum due to interruption of keeping information from the center to the body, headache, vomiting, increased intracranial pressure and swelling of the brain. In subarachnoid hemorrhage, in addition to neurological diseases, complications of repeated bleeding, particularly if the bulge of greater scope.

Other names: Intracranial hemorrhage, intracranial hemorrhage, stroke, subarachnoid hemorrhage, stroke, subdural hemorrhage, bleeding cluster

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