Why does hemiplegia occur in hypertensive cerebral hemorrhage?

  Hypertensive cerebral hemorrhage often occurs in the internal capsule or the external capsule, which is the place where the nerve conduction bundles are concentrated, and the corticospinal tract and the corticobulbar tract are responsible for the movement of the contralateral limb. Therefore, when the internal capsule is involved, the corticospinal tract and corticobulbar tract of the knee and posterior branch of the internal capsule are damaged, and contralateral hemiparesis occurs. In addition, the involvement of the posterior branch of the internal capsule of the optic radiation results in contralateral hemianopia; the involvement of the thalamocortical conduction bundle of the posterior branch of the internal capsule results in contralateral hemianesthesia. Because the external capsule is adjacent to the internal capsule, the external capsule hemorrhage is easily combined with the injury and edema of the internal capsule area, and the above three hemianopias appear.  In other words, in patients with hypertensive cerebral hemorrhage, in addition to contralateral limb hemiparesis, there are also contralateral hemianopia and hemianesthesia, that is, the so-called triple hemianopia syndrome, all occurring on the contralateral side of the hemorrhage.