Traditional Culture Encyclopedia - Traditional culture - Late treatment of brainstem hemorrhage
Late treatment of brainstem hemorrhage
The purpose of cerebral hemorrhage surgery is to remove hematoma, reduce the pressure on brain tissue, save lives and strive for the recovery of neurological function. However, whether cerebral hemorrhage can be treated surgically depends mainly on the bleeding site, the severity of the disease and the timing of operation.
Generally speaking, the bleeding site occurs near the external capsule, putamen and internal capsule, as well as superficial cerebral hemorrhage and cerebellar hemorrhage, which is the main indication of operation. Brain stem and thalamus hemorrhage, as the life center, can not tolerate surgical trauma, so it is not suitable for surgical treatment.
Young, systolic blood pressure is lower than 24 kPa (1.80 mm Hg), unconsciousness is not serious, medical treatment is ineffective, and the condition is deteriorating. Surgery should be done in time. If there are symptoms such as unequal pupils and increased intracranial pressure, it is suggested that there is hematoma formation, and emergency surgery is also needed. But over 70 years old, accompanied by heart disease, lung disease, liver disease, kidney disease and other organic diseases. , there is severe bleeding, and the amount of bleeding is more than 60 ml. Patients with critical illness and deep disturbance of consciousness have poor prognosis and high risk of operation, so they are not suitable for operation.
At present, there are three opinions on the timing of operation: first, it advocates ultra-early operation within 24 hours of bleeding. Second, early operation within 5 days after bleeding1~. Third, according to the condition, bleeding site and auxiliary examination, comprehensive consideration, flexible decision. At present, ultra-early surgery is advocated, and its advantage is that early removal of hematoma can reduce the secondary injury of brain tissue around hematoma. At the same time, it can stop bleeding as soon as possible and prevent hematoma from expanding, which can not only save lives, but also restore neurological function and reduce sequelae.
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