Popular science|Scientific life, stay away from cerebral hemorrhage

Original title: Popular science|Scientific life, stay away from cerebral hemorrhage

1. Is "cerebral hemorrhage" far away from us?

Intracerebral hemorrhage, also known as "cerebral hemorrhage," refers to spontaneous bleeding within the brain parenchyma that is not traumatic. The etiology is complex and closely related to many factors such as hypertension, diabetes, and vascular aging. With the improvement of the quality of life in modern society, the change of dietary habits, and the intensification of the aging trend of the population, the incidence of cerebral hemorrhage in mainland China is increasing year by year. According to statistics, the annual incidence of cerebral hemorrhage in mainland China is 12~15/100,000 people, of which 35~52% of patients unfortunately die in just one month, and only about 20% of patients can recover their ability to take care of themselves after six months of onset, and its mortality and disability rates are extremely high. Therefore, cerebral hemorrhage has become a "killer" that seriously endangers human health and life safety, and also brings a heavy economic burden to families and society.

In the face of the terrible "killer" of cerebral hemorrhage, we can't help but ask: how far away is it? In fact, the threat of cerebral hemorrhage is much closer than we think. Although middle-aged and elderly people aged 40~70 are still the main disease group, in recent years, young patients aged 30~40 are also common, and the age of onset shows a trend of younger age. The occurrence of intracerebral hemorrhage is not limited to a specific season or state, most cases occur in the cold season, and there are often obvious triggers such as emotional agitation, but it also occurs in the warm season and quiet state. Therefore, we must not take cerebral hemorrhage lightly and should take precautions to prevent it from occurring.

2. Common causes of intracerebral hemorrhage

1. Hypertension: Hypertension is the most common cause of cerebral hemorrhage, especially for patients with hypertension who have been untreated or improperly treated for a long time. Long-term high blood pressure can cause the walls of the cerebral arteries to become thinner, vitreous or hardened, and more brittle, and when blood pressure rises suddenly, these blood vessel walls are prone to rupture, leading to intracerebral hemorrhage.

2. Cerebrovascular malformation: Cerebrovascular malformation is another important cause of cerebral hemorrhage, common in young people, and its mechanism is usually abnormal proliferation or expansion of cerebral blood vessels during development, forming abnormal vascular networks, and the vascular walls of these lesions are weak and easy to rupture and bleed. Common cerebrovascular malformations include arteriovenous malformations, moyamoya disease, cavernous hemangiomas, etc.

3. Aneurysm: A cerebral aneurysm is an abnormal protrusion on the wall of a blood vessel in the brain, similar to a "balloon" on the wall of a blood vessel. This "balloon" gradually grows larger with age, and the "ball wall" becomes thinner and prone to rupture. Once ruptured, blood can quickly rush into the subarachnoid space, causing severe subarachnoid hemorrhage, which can lead to serious health problems and even life-threatening.

4. Cerebrovascular amyloidosis: Cerebrovascular amyloidosis is a chronic, progressive vascular lesion, mainly seen in the elderly. It is characterized by the deposition of amyloid in the walls of cerebral blood vessels, which causes the walls of blood vessels to thicken, harden, lose their elasticity, and rupture easily.

5. Blood disorders: Certain blood disorders can lead to coagulation dysfunction or increased fragility of blood vessels, which increases the risk of intracerebral hemorrhage. Common diseases include leukemia, aplastic anemia, thrombocytopenic purpura, etc.

6. Anticoagulation or thrombolytic therapy: Anticoagulation or thrombolytic therapy is an important means to prevent and treat thrombotic diseases, but in the process of treatment, it sometimes leads to the occurrence of cerebral hemorrhage. This is mainly because anticoagulant or thrombolytic drugs can weaken blood clotting.

7. Smoking, alcohol and other bad habits: the harm of smoking to health has been widely recognized, nicotine, tar and other harmful substances in tobacco can damage vascular endothelial cells, accelerate vascular aging, and increase vascular fragility. At the same time, smoking can also lead to an increase in blood pressure and heart rate, further increasing the burden on the cerebrovascular system. The combined effect of these factors greatly increases the risk of intracerebral hemorrhage in smokers. Long-term heavy alcohol consumption can lead to metabolic disorders in the body, especially abnormal fat metabolism, which in turn leads to diseases such as hyperlipidemia and high blood pressure. In addition, alcohol can directly stimulate the cerebral blood vessels, causing them to spasm or dilate, which can easily lead to cerebral hemorrhage. In addition to smoking and alcoholism, unhealthy diet, lack of exercise, overwork and other unhealthy lifestyle habits can also increase the risk of cerebral hemorrhage.

8. Emotional agitation: In the fast-paced modern life, we often face various stresses and emotional swings. When emotionally charged, our bodies release large amounts of stress hormones such as adrenaline and norepinephrine. These hormones cause a rapid heart rate and a sharp increase in blood pressure, which can trigger a brain hemorrhage.

3. Symptoms of cerebral hemorrhage

The onset of intracerebral hemorrhage is usually sudden, and its symptoms vary depending on the individual, the location of the bleeding and the amount of bleeding, and the following common symptoms are usually present:

1. Sudden, severe headache: The patient will suddenly feel a severe headache that is different from the usual headache feeling, more severe and unbearable.

2. Nausea and vomiting: Increased intracranial pressure can cause nausea and vomiting in patients.

3. Impairment of consciousness: As the amount of bleeding increases, patients may experience symptoms such as confusion, drowsiness, and even coma.

4. Language and motor disorders: If the bleeding occurs in a specific area of the brain, such as the speech cortex or the motor cortex, the patient may experience slurred speech, difficulty in expression, or weakness, numbness, or even paralysis in one limb.

5. Visual impairment and eye abnormalities: Patients may have symptoms such as double vision, visual field defects, or decreased vision. When intracranial pressure is markedly elevated, the patient's eyeball may protrude outward, and brain herniation may cause abnormal manifestations such as dilated pupils or loss of light reflex.

6. Other symptoms: dizziness, balance disorders, difficulty swallowing, choking on drinking water, incontinence and other symptoms may also occur.

4. Preventive measures for intracerebral hemorrhage

1. Stabilize blood pressure: monitor blood pressure regularly, take medication on time and in accordance with the doctor's instructions, and avoid stopping or adjusting the dose by yourself. If blood pressure is not well controlled, seek medical attention in time to adjust the treatment plan.

2. Maintain optimism: Pay attention to mental balance, maintain an optimistic attitude, maintain a happy mood, and learn relaxation techniques to relieve stress, such as deep breathing, yoga, meditation, which can help reduce the risk of cerebral hemorrhage.

3. Develop a healthy lifestyle: quit smoking and limit alcohol, maintain regular living habits, participate in sports activities moderately, arrange work reasonably, ensure adequate sleep and rest time, and avoid overwork.

4. Reasonable diet: Maintain a balanced diet, moderate intake of protein, fat, and carbohydrates, and avoid excessive intake of high-calorie, high-fat, high-salt, and high-sugar foods. Eat more vegetables, fruits, and soy products, with an appropriate amount of lean meat, fish, and eggs, and eat less animal brains and offal.

5. Prevention and treatment of constipation: abdominal massage in the morning, use laxative drugs if necessary, such as oral hemp seed pills, honey, external use of cork and glycerin.

6. Pay attention to climate change: Pay attention to keeping warm in cold days, and moderate activity and exercise to promote blood circulation, such as walking, doing radio gymnastics, to adapt to climate change.

7. Regular physical examination: Regular physical examination can detect risk factors such as hypertension and cerebrovascular disease as early as possible, and take corresponding prevention and treatment measures. It is recommended to check the cranial CTA, and at least once a year to have a comprehensive physical examination, including blood pressure, blood lipids, blood sugar and other indicators.

8. Moderate exercise: Moderate exercise can help maintain a healthy weight, enhance cardiovascular function, and improve immunity. It is recommended to do 180 minutes of moderate-intensity aerobic exercise per week, such as brisk walking, swimming, cycling, etc. Strength training is performed at the same time to strengthen muscles and bones.

5. Pre-hospital first aid measures for cerebral hemorrhage

The mortality and disability rates of intracerebral hemorrhage are very high, and timely and appropriate pre-hospital emergency care is crucial to improve the survival rate, reduce sequelae, and improve the quality of life. If symptoms are suspected, first aid should be taken immediately, and the following are the key points of prehospital care for intracerebral hemorrhage:

1. Family members should stay calm, immediately let the patient lie down to rest, avoid emotional agitation, and call an ambulance urgently.

2. While waiting for the ambulance, the patient's collar and belt should be loosened, the dentures (if any) should be removed, the head should be tilted to one side, and the foreign body in the oral cavity should be cleaned up in time to avoid blocking the respiratory tract and causing suffocation and aspiration pneumonia.

3. If the patient is unconscious and snoring loudly, the base of the tongue may fall, and the tongue can be wrapped in a handkerchief or gauze and gently pulled out to keep the airway open.

4. If the patient falls in a small space such as a toilet or storage room, he or she should be moved to a spacious area, and the indoor air circulation should be maintained, and attention should be paid to keeping warm or cooling.

5. You can cover your head with a cold towel, and the blood vessels will shrink when it is cold, which can reduce bleeding.

6. If there is incontinence, it should be dealt with on the spot and not move the body at will.

7. During the patient's transport, the vehicle should drive as smoothly as possible to reduce bumps and vibrations, and at the same time, the head can be slightly raised to pay attention to the changes in the condition at any time.

In short, although cerebral hemorrhage is extremely harmful, we do not need to worry too much, as long as we adopt a scientific lifestyle, we can effectively reduce the risk of its disease. Once there are suspicious symptoms, stay calm, deal with them scientifically, seek medical attention in time, and follow the doctor's treatment and rehabilitation strategies. From now on, let's pay attention to the health of ourselves and our families, live scientifically, stay away from the threat of cerebral hemorrhage, and enjoy a healthy and beautiful life.

Authors: Liao Huan, Han Sheng, Zhao Changyi, Wang Wei, Department of Neurosurgery, Shanghai Fourth People's Hospital

(Liao Huan, Han Sheng, Zhao Changyi, Wang Wei)