Intracerebral hemorrhage

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Hemorrhagic stroke is less common than ischemic, but the prognosis with this disease is much more serious. Often, intracerebral hemorrhage develops at a young age, as there is a rupture of congenital aneurysm or vascular malformation against background of situational lifting of arterial pressure, for example during stress.

There are two types of hemorrhage in the brain - a hemorrhage on the type of hematoma and the type of hemorrhagic impregnation - differ not only in pathogenesis, but also in the clinical picture.

In order for the gap to occur, the vessel wall needs to be changed. Most often, a hemorrhagic stroke develops against a background of arterial hypertension, in which the wall of small and medium arterioles thickens and loses its elastic properties. Due to the degeneration of elastic fibers, the artery can not adequately respond to changes in blood pressure, and when the pressure rise above the usual figures there is a rupture of the vessel.

In addition to changes in the walls of arterioles against the background of arterial hypertension, vessel rupture may occur with the following pathology:

  • Aneurysm of the arterial wall;
  • Arteriovenous malformation;
  • Angiomas;
  • Defeat of the arteriol wall in amyloid angiopathy (characteristic of senile age).

The combination of a changed vessel wall and a rise in blood pressure (not necessarily against a background of arterial hypertension, and, for example, under physical activity) leads to a rupture of the wall in the defect area. In the above cases, the rupture of the wall leads to the formation of a hematoma.

Also, intracerebral hemorrhage can occur on the background of diseases or conditions that reduce the viscosity and coagulation properties of the blood. In these cases, hemorrhage occurs in the type of hemorrhagic impregnation. These include:

  • Thrombocytopenia;
  • hemophilia;
  • Leukemia;
  • Anticoagulant and thrombolytic therapy;
  • Severe liver failure.

Intracerebral hemorrhage can also be a complication of the primary brain tumor or the process of metastasis in the brain.

When a blood vessel ruptures, blood may enter not only in the nerve tissue at the point of rupture, but also in the subarachnoid space, in the ventricles of the brain. In this case, intracranial pressure rises due to an increase in fluid volume in the limited amount of the skull due to the pouring blood. Brain edema develops. Blood in the subpuntal space compresses the brain vessels, irritation of the cerebral membranes leads to vascular spasm - both processes intensify the ischemia of the nerve tissue.

The degree of severity of cerebral edema and associated symptoms depends on the volume of pouring blood. In small hematomas, intracerebral hemorrhage clinically resembles an ischemic stroke and proceeds without cerebral and meningeal symptoms.

Intracerebral hemorrhage

Category Of Medical Issues: Diseases

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