Symptoms of a hematoma of the brain
Hematoma of the brain is a limited accumulation of blood in the substance of the brain, which exerts compressive and damaging effects on the surrounding brain tissue.
General information about education and the impact of the hematomas on the person
Intracerebral hematoma is characterized by the appearance of cerebral and focal symptoms, which is completely dependent on the place of formation and size of the formed hematoma.
The most accurate diagnosis of pathological disorders is obtained with the use of computer and magnetic resonance tomography of the brain, besides an excellent picture of the disturbances that occur receive when using angiographic examinations of the vascular system of the brain. Small in size and volume of the hematoma in the brain can be treated by using conservative treatment methods. In the formation of extensive intracerebral hematomas treatment is done by surgical intervention with removal or aspiration.
The resulting hematoma within the brain may consist of liquid and coagulated blood. In some situations, the resulting hematoma is not only the blood components, but also of detritus, which amount is significantly inferior to the accumulation of blood components. The volume of blood that can fit in the formed cluster may vary from 1 to 100 ml. in the Process of increasing the volume of blood pooling occurs at 2-3 hours after the occurrence of bleeding. A longer accumulation of blood occurs if there is a disruption of the coagulation mechanism.
Accumulated as a result of bleeding, the blood puts pressure on brain tissue, which provokes damage and necrosis of the cells of the tissues composing the brain. In parallel with the pressure tissue hemorrhage forming in the brain causes increase in intracranial pressure that can cause the development of edema of the brain. Hemorrhage of large size able to cause displacement of structures and lead to the development of signs of dislocation syndrome.
Hemorrhage leads to reflex spasm of blood vessels, which contributes to the development of ischemic lesions of tissues located in close proximity to the hemorrhage. Ischemia becomes damaging an additional factor that leads to the spread of pathological change beyond the region emerged bleeding.
The reasons for the developmentintracerebral hemorrhage and their classification
Causes of hematoma of the brain can be varied. One of the most common causes is the rupture of a vessel of the circulatory system as a result of injury. In addition, the occurrence of hemorrhage may be the result of education gaps or aneurysm with arteriovenous malformations, as the result of arrosive bleeding in the development of intracerebral tumors. Simultaneously, the causes of hemorrhage may include:
- the development of hemorrhagic stroke;
- violation of the integrity of the blood vessels when you change their elasticity resulting in the development of atherosclerosis, systemic vasculitis, diabetic macroangiopathy.
The appearance of the hemorrhage can be the consequence of pathological changes in the blood properties in the presence of the victim's body of ailments such as hemophilia, leukemia, hepatitis and cirrhosis. Bleeding can cause a drugs that has anti-clotting properties, and taken in the treatment of certain ailments.
The medical specialists klassificeret all hemorrhages in the brain in several varieties depending on the location, size and etiology. Depending on the localization of the hematoma is divided into:
- of cortico-subcortical intracerebral;
- hematoma in the cerebellum.
In addition to this, there are hemorrhage, lobar, medial, lateral and mixed. Depending on the volume of all hemorrhages are divided into small, medium and large.
Depending on the reasons education can distinguish hematoma post-traumatic, hypertensive, and aneurysmal tumor. Bleeding in the cavity between the arachnoid and the soft membranes is called a subarachnoid hematoma. This blood is formed as a result of injury and rupture of arterial aneurysm. Most often this bleeding occurs spontaneously without significant warning signs. This type of hematomas of the brain is one of the most dangerous and most often leads to disability even with early diagnosis and adequate treatment.
The symptoms of the formation of intracerebral hemorrhages
In most cases, intracerebral bleeding accompany symptoms. The patient feels dizziness, severe headache, nausea and vomiting. More than 50% of cases characterized by the occurrence of disturbances in human consciousness from stupor to coma. Sometimes before the development of the oppressedof consciousness there is a period of sharp psychomotor excitation. Sometimes the formation of a hemorrhage can occur with the emergence of the light period in the condition of the victim.
Focal symptoms are manifestations of disorders are entirely dependent on the amount of hemorrhage and its localityaware. So, for example, in the formation of a small bleed in internal capsule is observed the formation of a more pronounced neuroleptica than in the formation of large volume of bleeding that are located in less important areas. Most often, the education gematologa formation is accompanied by the occurrence of hemiparesis and aphasia. The man is a violation of tactile sensitivity, there is imbalance in the tendon reflexes, in addition to this, you may experience convulsive epileptic seizures. In addition, you can experience such signs as:
- a disorder of memory function;
- disorders in behavior.
Education extensive bleeding in the brain lead to the progression of dislocation syndrome, which develops as a result of pressure on brain structures and their displacement. Hemorrhage, increasing the volume of the contents of the skull, leads to displacement of structures in the caudal direction. This shift leads to herniation of the cerebellar tonsils in the foramen Magnum. The result of these actions is the appearance of compression of the structures of the medulla oblongata.
Intracerebral hemorrhage with the advent of penetration of blood in the cavity of the ventricles can cause the following consequences:
- oppression of consciousness until coma;
- the occurrence of meningeal symptoms;
- gorodnichanka the appearance of seizures, which are characterized by a paroxysmal increase in muscle tone.
Intracerebral hemorrhage deferred nature of the manifest lack of improvement in health and a sharp deterioration some time after the injury.
Diagnosis and treatment of intracerebral hemorrhages
Application of the latest neuroimaging techniques provides an opportunity not only to conduct a diagnosis of the hemorrhage, but also to identify the cause leading to the occurrence of the violation. One of the main methods of diagnosis is computed tomography. Tomography bleeding has the appearance of a homogeneous seal with a rounded or oval shape. In the case of the formation of hemorrhage as a result of the injury, the hematoma has jagged edges. Over time, a decrease indensity gematologa education to the density of the surrounding tissues. For small hemorrhages this period is 3 weeks and for secondary bleeding period is 5 weeks.
For the detection of vascular disorders used angiography and MRA. As an independent method angiography cannot be used because it does not allow to accurately perform differentiation between site of injury and hematoma.
Treatment of intracerebral hemorrhage is conservative and operative methods.
The decision to use one or another technique adopts the attending physician on the basis of the survey and the individual characteristics of the patient. Using the methods of conservative medicine is under the control of computer tomography. The use of conservative treatment is possible when the value of education not more than 3 cm in diameter and a satisfactory state of health of the patient. In addition, the patient should be observed dislocation syndrome and compression of the oblong Department. When conservative treatment is used gemostatiki and drugs reduce the permeability of the vascular system. In the process of treatment is prevention of thromboembolism and correction of pressure.
When forming the plural of hemorrhage or the formation of large used methods of surgical intervention. During the intervention, carried out the removal of most effusions. In case of intracerebral effusion combined with the formation of gematologa the formation of shells, removal of hemorrhage is carried out simultaneously with the partial removal of a subdural hematoma.
After the implementation of operative intervention the patient required prolonged postoperative recovery period.