Clinical manifestations of cerebral hemorrhage in different parts of the brain

(1) Internal capsule hemorrhage: It is the most common site of hemorrhage. Its typical clinical manifestation is contralateral “three partialities” (hemiparesis, hemiplegia, hemianopsia, hemianopsia). The scope of internal capsule hemorrhage is larger, and the symptoms of neurological damage are more serious. However, if the hemorrhage is on the outside of the internal capsule and mainly damages the external capsule, the clinical symptoms will be lighter and there will be no consciousness disorder, hemiparesis will be light, and the prognosis will be better. (2) Thalamic hemorrhage: If the hemorrhage is on one side of the thalamus and the amount of hemorrhage is small, the patient will have light paralysis on the opposite side, and hemiplegia on the opposite side, especially the proprioceptive disorder is obvious. If the amount of hemorrhage is large and the damaged part spreads to the opposite side of thalamus and the lower part of thalamus, then there will be vomiting of coffee-like material, frequent vomiting in the form of jet, and polyuria, urinary sugar, quadriplegia, and gaze of both eyes to the tip of the nose. The condition is often critical and the prognosis is not good. (3) Lobar hemorrhage: also known as subcortical white matter hemorrhage, can occur in any lobe of the brain. In addition to headache and vomiting, the clinical manifestations of hemorrhage in different lobes are also different. For example, frontal lobe hemorrhage may present mental symptoms, such as restlessness, doubt, contralateral hemiparesis, motor aphasia, etc.; parietal lobe hemorrhage may present contralateral sensory disorder; temporal lobe hemorrhage may present sensory aphasia, mental symptoms, etc.; occipital lobe hemorrhage is most common in hemianopsia. Lobar hemorrhage is generally less severe, and the prognosis is relatively good. (4) Pontine hemorrhage: Pontine hemorrhage is the most common part of brainstem hemorrhage. Early manifestation of hemiplegia on the side of the diseased area and the opposite side of the limb is called cross paralysis. This is the clinical characteristic of pontine hemorrhage. If the hemorrhage is large, it affects the opposite side, and there are limb paralysis, pupil narrowing, high fever, coma and so on; if the blood breaks into the fourth ventricle, then there are serious symptoms such as convulsions, irregular breathing and so on, and the prognosis is not good; (5) Cerebellar hemorrhage: if the hemorrhage is small, the clinical manifestation is often dizziness, followed by severe headache, frequent vomiting, unstable walking and unclear speech; if the hemorrhage is large, it compresses the medulla oblongata life center, and the severe cases can die suddenly. If the hemorrhage is large and compresses the vital center of medulla oblongata, the severe cases may die suddenly. (6) Ventricular hemorrhage: generally divided into primary and secondary, primary ventricular hemorrhage is intracerebral choroid plexus rupture and bleeding, which is rare. Secondary hemorrhage is due to the large amount of intracerebral hemorrhage, which penetrates the brain parenchyma and flows into the ventricle. Clinical manifestations include vomiting, excessive sweating, and purple or pale skin. One to two hours after the onset of the disease, the patient falls into a deep coma, high fever, limb paralysis or tonic convulsions, unstable blood pressure, and irregular respiration. The disease is mostly severe and has a poor prognosis.