Prevention and control of cerebral hemorrhage after cerebral infarction

  Post-infarction cerebral hemorrhage refers to secondary hemorrhage within the infarcted area caused by the reperfusion of blood vessels in the ischemic area during cerebral infarction, with scattered or limited high-density shadowing within the original hypodense area as shown on brain CT scan or brain MRI. This phenomenon is called hemorrhagic cerebral infarction or post-infarction cerebral hemorrhage. Due to the popularization of CT, MRI and other imaging applications, especially MRI, there is a gradual trend of increasing reports of hemorrhagic cerebral infarction, which has attracted clinical attention.  Compared with CT, MRI has more advantages in diagnosing cerebral hemorrhage after infarction. Not only can it diagnose cerebral hemorrhage as well as CT, but it can also detect and diagnose cerebral microvascular hemorrhage, which is inferior to CT general examination, and it can also detect and diagnose cerebral hemorrhage in the subacute stage and later stages, while CT cannot confirm cerebral hemorrhage at this time due to the decrease of density ratio between brain tissue and hemorrhage foci, in addition, for The advantages of CT are the relatively low cost and fast examination time, which has been shortened to 1 minute in recent years due to technological advances, while the average examination time of MRI is still longer, 10-20 minutes.  The main causes of post-infarction cerebral hemorrhage are heart disease, hypertension atherosclerosis, hyperlipidemia, diabetes, etc. Therefore, we should strengthen the control of the causes that may cause hemorrhagic infarction, such as actively controlling heart disease, reasonably adjusting blood pressure, and lowering high blood sugar. Because the infarction is in the first place, the treatment process may not be able to avoid cerebral hemorrhage, so once the patient’s condition suddenly transforms or worsens during the treatment period, the head MRI or CT examination must be performed again in order to clarify the condition and treat it correctly.  In clinical work, some patients refuse to be examined again because of the cost of examination, which may delay the disease, which is a noteworthy problem.