Cerebral hemorrhage with brain herniation should be treated immediately with emergency surgery to remove the hematoma.
Cerebral hemorrhage with cerebral hernia is usually caused by a large hematoma formed by cerebral hemorrhage. The occupying effect obviously leads to intracranial pressure increase and brain tissue compression caused by cerebral hernia. Clinical manifestations vary depending on the site and herniated tissue.
In case of temporal sulcus hernia, occipital foramen magnum hernia, and canopy incisional hernia, the patient may die of respiratory and cardiac arrest before resuscitation. In case of brain herniation due to cerebral hemorrhage, emergency treatment should be given first to maintain vital signs and mannitol should be given intravenously to reduce intracranial pressure.
For patients in whom the nature and location of the lesion has been clarified, the intracranial hematoma should be removed urgently at the same time to reduce the pressure on the brain tissue and to restore the damaged neurological function as much as possible. If it is not clear, surgery or palliative decompression (e.g., subtemporal decompression) should be performed as soon as possible after improved examination.
If the patient has sudden symptoms of cerebral hemorrhage combined with cerebral herniation, such as sudden pupil changes and changes in vital signs, immediate medical attention and resuscitation should be provided.