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急性脑出血是脑实质内动脉壁坏死、破裂出血。出血后因脑内形成血肿以及血液刺激脑室和脑膜引起脑水肿,导致颅内压增高。临床表现为剧烈头痛、呕吐、意识障碍、血压升高及神经系统局灶体征。急性大面积脑梗塞是颈内动脉或大脑中动脉主干完全性闭塞,而导致大脑半球的大部分脑组织缺血坏死。临床表现为突然昏迷,伴有严重的神经系统局灶体征。 1 症状 脑出血发生意识障碍,是因脑实质内大量出血,使颅内压急性升高影响到大脑皮质及网状上行系统,使脑功能障碍所致。其昏迷、生命体征(呼吸、心律不齐等)的不稳定及血压突然明显增高。皆由颅内压异常升高所致,因颅腔内压力增高,使原先的血压水平不足以维持正常脑灌注,于是通过脑干血压调节中枢反射性地提高血压,以克服增高的颅内压而维持足够的脑血流量,这属一种病理生理代偿机制(如血压反而下降,则表示病情极为严重)。此时,若用一次甘露醇降颅压,血压就会有所下降,不需要用猛烈降压药来降低血压,生命体征也会趋于稳定。
Acute cerebral hemorrhage is intra-arterial wall necrosis of the brain, rupture of bleeding. Hemorrhage due to brain formation of hematoma and blood to stimulate the brain and brain caused by cerebral edema, leading to increased intracranial pressure. Clinical manifestations of severe headache, vomiting, disturbance of consciousness, elevated blood pressure and nervous system focal signs. Acute large area cerebral infarction is the complete occlusion of the internal carotid artery or middle cerebral artery trunk, leading to ischemic necrosis in most of the cerebral hemispheres. Clinical manifestations of sudden coma, with severe nervous system focal signs. 1 Symptoms of cerebral hemorrhage occurred in disturbance of consciousness, due to a large number of intraparenchymal hemorrhage, so that an increase in intracranial pressure affect the cerebral cortex and reticular uplink system, so that brain dysfunction. Its coma, vital signs (breathing, arrhythmia, etc.) instability and sudden increase in blood pressure was significantly higher. Are caused by an abnormal increase in intracranial pressure due to increased intracranial pressure so that the original blood pressure level is not enough to maintain normal cerebral perfusion, so by the brainstem blood pressure regulation central reflex to raise blood pressure, in order to overcome the increased intracranial pressure and Maintain adequate cerebral blood flow, which is a pathophysiology compensatory mechanism (such as blood pressure but decreased, it means the condition is extremely serious). At this point, if a drop of mannitol intracranial pressure, blood pressure will decline, do not need to use a violent antihypertensive drugs to lower blood pressure, vital signs will tend to be stable.