Surgery to clean up the edema of patients with cerebral hemorrhage and repair the damaged cerebral blood vessels is undoubtedly a better treatment method, but general patients and their families often have a fear of craniotomy.
Therefore, it is necessary for patients and their families to understand the indications of surgery.
Generally speaking, surgical treatment of stroke patients with cerebral hemorrhage should be under 60 years old, blood pressure is not too high, heart, liver and kidney function is good, and one of the following can be considered:
- after conservative treatment in internal medicine, the patient improved for a time and then aggravated, and also had high intracranial pressure, which indicated that there was hematoma formation in the brain.
- the disease is mild at the beginning, but worsens after medical diagnosis and treatment, indicating that the disease has developed again.
- although brain herniation has been caused by increased intracranial pressure, and the patient has a deep coma, the circulatory system and respiratory system function are still good.
- patients with cerebellar hemorrhage.
Age characteristics of stroke
Stroke, also known as stroke or cerebrovascular accident, is different from cerebral hemorrhage, subarachnoid hemorrhage, cerebral thrombosis and cerebral embolism. Among them, the former two are hemorrhagic changes of cerebral vessels, while the latter two are ischemic changes. The age of onset is also very different, which can be used as a reference for clinical differentiation. Intracerebral hemorrhage is commonly seen in the rupture and hemorrhage of cerebral atherosclerosis, so it is common in the elderly over 50-60 years old; Cerebral thrombosis can be caused by hyperlipidemia, arteriosclerosis or other external factors, so the prevalence rate is high above middle age.
Cerebral embolism is most often secondary to various cardiac fibrillation, fracture, tumor, intravenous injection, artificial pneumothorax, pneumoperitoneum and other operations, so it is mostly seen in young and middle-aged people. Subarachnoid hemorrhage is caused by congenital malformations of cerebral vessels and rupture of aneurysms, and the incidence is independent of age, so it can occur in young, middle-aged and old people.
Inferring stroke type according to symptoms
Experienced physicians can often infer which kind of stroke disease they belong to according to the urgency of stroke onset, the causes of stroke and the presence or absence of premonitory symptoms. Generally speaking, the onset of cerebral hemorrhage is sudden, often after emotional agitation and overwork, and the disease progresses rapidly; Subarachnoid hemorrhage also occurs suddenly, often accompanied by severe headache; Cerebral thrombosis generally starts slowly, with prodromal symptoms such as dizziness, numbness of hands and feet, and more at night.
Often in the morning, patients wake up and find that their hemiplegia, hemiplegia, language disorder and other symptoms are gradually increasing. Cerebral embolism is also a sudden onset, but neurological symptoms such as hemiplegia, oropharyngeal deviation and so on appear rapidly, without a gradual evolution process.
The risks associated with surgery for cerebral hemorrhage
The risks associated with surgery for cerebral hemorrhage can vary significantly depending on a multitude of factors, including the location and volume of the bleeding, the overall health condition of the patient, and the timing of the surgery. Generally, the procedure carries inherent risks such as those related to anesthesia, which can be particularly concerning for patients with pre-existing cardiovascular issues or other health concerns. Additionally, there are potential complications that can arise during the surgical intervention itself, such as infections, excessive bleeding, or damage to the surrounding brain tissue.
Post-surgical risks may include the possibility of neurological deficits due to injury to the brain during the operation, which could manifest as paralysis, speech difficulties, or other impairments. Furthermore, there is a risk of re-bleeding after the surgery, which can be life-threatening. Patients also face the possibility of complications during the recovery period, such as pneumonia or deep vein thrombosis.
The decision to proceed with surgery is typically made after a thorough evaluation by a neurosurgeon, who will consider the individual’s specific circumstances and weigh the potential benefits of surgery against these risks. For some patients, surgical intervention may be crucial for saving lives or significantly improving prognosis, while for others, conservative management might be a more appropriate course of action. Therefore, the specific risks of surgery should be discussed in detail with a qualified neurosurgeon to ensure that the patient is fully informed and that the treatment plan aligns with their individual needs and circumstances.
