How should brain hemorrhage be treated?

  Cerebral hemorrhage is a primary non-traumatic brain parenchymal hemorrhage. Hypertension is the most common cause of cerebral hemorrhage. Hypertension with small arterial lesions in the brain and sudden rise in blood pressure causing arterial rupture and bleeding is called hypertensive cerebral hemorrhage.  Other causes include atherosclerosis, blood diseases (leukemia, aplastic anemia, thrombocytopenic purpura, hemophilia, etc.), cerebral amyloid angiopathy, cerebral arteritis, etc.  The onset of clinical manifestations usually occurs during emotional excitement, and most of them have no aura before the disease, and a few have headache and dizziness. The main clinical manifestations include sudden onset of headache, vomiting, lack of clarity, numbness of half limbs, inability to move, lack of clarity in seeing, even coma, frequent vomiting, tonicity of limbs, and death.  Treatment: 1. Internal conservative treatment: According to the CT examination results, if the bleeding in the brain parenchyma, cerebral hemisphere ≤ 20ml, cerebellar hemisphere ≤ 10ml, and not accompanied by increased intracranial pressure, internal conservative treatment is feasible. Such as oxygenation, (mannitol, glycerol fructose) dehydration, diuresis, blood pressure control, preventive treatment of complications such as pulmonary infection, gastrointestinal bleeding, seizures, central hyperthermia, deep vein thrombosis of the lower limbs, etc.  2.Surgical treatment: The purpose of surgery is to save the patient’s life, and to promote the recovery of neurological function.  Indications for surgery: (1) no obvious dysfunction of heart, liver, kidney and other important organs; (2) cerebral hemisphere >20ml, cerebellar hemisphere >10ml; (3) ventricular system hemorrhage with hydrocephalus and increased intracranial pressure; surgical methods include open hematoma removal, extraventricular drainage, cone hole aspiration of hematoma, etc.  3, special treatment: (1) non-hypertensive cerebral hemorrhage: such as the treatment of hematological diseases; (2) multiple cerebral hemorrhage: hypertensive atherosclerosis, amyloid angiopathy, hematological disease is a common cause, the etiology of treatment should be performed, but the launch of poor prognosis; (3) prevention and control of rebleeding, cerebral hemorrhage reoccurrence rate of about 10%, control of blood pressure is the key; (4) unstable cerebral hemorrhage: can be due to high blood pressure, long-term heavy alcohol consumption (4) Unstable cerebral hemorrhage: can be due to high blood pressure, long-term heavy alcohol consumption, etc., the condition can continue to worsen or deteriorate.  The mortality rate of patients with cerebral hemorrhage is about 40%, and cerebral edema, increased intracranial pressure and brain herniation are the main causes of death.