Author/senior medical media person Ady (WeChat official account: Ady reads health for you)
Interviewed expert: Miao Zhongrong, chief physician of interventional neurology department of Beijing Tiantan Hospital affiliated to Capital Medical University.
The story behind a short message is chilling.
"Old Samuel! Come and have a look! Lao Chen, the class teacher, was sent to the hospital this morning for a sudden cerebral hemorrhage and is being rescued! " Miao Zhongrong, a famous expert in interventional neurosurgery, had just finished a difficult interventional operation of brain surgery when he received this hot news from his classmates in Lanzhou University.
After working for decades, I have treated so many stroke patients, but Miao Zhongrong was surprised that this disease happened to his classmates. After all, Kerwin Chen studied medicine, and she was fine at the reunion a month ago. Miao Zhongrong put down his work and immediately bought a plane ticket to Lanzhou. How did Mr Miao's classmates end up?
Cerebral hemorrhage, something you don't know at all.
Although after emergency treatment, Mr. Chen's life is no longer in danger, Miao Zhongrong is still very unhappy to see his old classmate lying helpless in the hospital bed. The attending doctor told him that the bleeding area is not very large, but because the bleeding location is in the functional area of the brain, he can't talk or move now. Mr. Chen studied medicine. Instead of becoming a doctor, he started a medical business, and the business was delayed again and again.
Figure 1: schematic diagram of brain structure and function
Cerebral hemorrhage is a manifestation of stroke. Compared with cerebral ischemia, another manifestation of stroke, bleeding seems to be more life-threatening. The brain is a sophisticated instrument. God divides our brain into two hemispheres, and the two hemispheres have different functions (as shown above, 1). The left hemisphere controls our language function, and the right hemisphere controls our limb movement function. If there is cerebral hemorrhage in the left brain, there will be motor aphasia, that is, you can understand what others say but can't say it. Or sensory aphasia, that is, you can speak without understanding what others are saying. The two hemispheres of the brain are divided into many leaves, such as frontal lobe and occipital lobe. If the occipital lobe is damaged, you may not see.
Adult cerebral hemorrhage is mostly caused by hypertension.
But how can a good person suddenly have a cerebral hemorrhage? Mr. Chen's wife said with regret that there are still some clues in retrospect. The night before the onset, Mr. Chen drank a large glass and couldn't speak when he got home, but they thought it was because he drank too much and his tongue was short, so he didn't take it to heart. Mr. Chen fell asleep after taking three aspirin. But he couldn't get up and talk the next day.
What is the cause of cerebral hemorrhage in Lao Chen? It turns out that Mr. Chen has suffered from hypertension for many years, and the highest can reach 180 mm Hg. Although I study medicine, I never pay attention to my health, never have a physical examination every year, and I usually don't use drugs to control high blood pressure. Miao Zhongrong, an old classmate, sends out "Little Doctor Comics" every day, but he doesn't read them. Coupled with work reasons, I often have to socialize with customers and drink a lot of wine, thus forming a vicious circle.
Miao Zhongrong said that the main cause of cerebral hemorrhage in our country is hypertension, which can reach more than 50%. Nevertheless, we can control the cerebral hemorrhage caused by hypertension. The incidence of stroke in the United States is decreasing year by year because they control their blood pressure well. In autumn and winter, due to the great climate change, blood pressure is easy to fluctuate and difficult to control. Mr. Chen had a sudden cerebral hemorrhage, which added fuel to the fire. It was three aspirin he took before going to bed.
Why does aspirin become the fuse of cerebral hemorrhage?
Miao Zhongrong said that because aspirin is an anticoagulant, it has a certain effect on the prevention of cerebral ischemia (cerebral infarction). On the contrary, it will aggravate the occurrence of cerebral hemorrhage, even bleeding, and endanger life. Aspirin can prevent cerebral hemorrhage, which is a misinformation that harms others and yourself! Once you suspect the precursor of a stroke, what you should do immediately is to call an ambulance immediately. This shows how important it is to master reliable health knowledge at ordinary times.
Figure 2
Figure 3
Lao Chen is really lucky this time! The bleeding place is not too fatal, you know? Among the patients with cerebral hemorrhage, 40% are subarachnoid hemorrhage, that is, a hemangioma has grown in the brain, and this hemangioma has ruptured. To put it bluntly, hemangioma in the brain is a bubble bulging from the cerebral blood vessels (as shown in Figure 3 above), which is easy to rupture. Once ruptured, the first mortality rate is 25%.
Figure 4
Then there was brain stem bleeding, most of which could not be saved. We can find the answer from the brain structure diagram (Figure 4 above), because the internal structure of the brain is getting smaller and smaller, and the brain stem area is basically narrowed. This place is the center of human respiration and circulation. Once the brain stem bleeds, breathing and heartbeat will stop.
The truth of young people's cerebral hemorrhage is amazing!
I don't know if you are concerned about one thing that happened in these two days. A 13 middle school student in Shenzhen was rushed to the hospital for cerebral hemorrhage. The area of bleeding is much larger than that of Mr. Chen. Fortunately, the child was finally saved after the hard rescue of medical staff.
In our impression, cerebral hemorrhage seems to be only for the elderly. However, this is not a case among young people. During Dr. Miao Zhongrong's career, I have also seen many cases of cerebral hemorrhage among young people. You must want to know why young people also have cerebral hemorrhage.
Miao Zhongrong said that the main cause of cerebral hemorrhage in young people or children is cerebrovascular malformation. Most cerebrovascular malformations are congenital cerebrovascular malformations. The arteries and veins of the brain should grow smoothly and regularly, but now the blood vessels in this place are in a mess, like a ball of wool.
Originally, the blood vessel wall was very thin, about two millimeters. People with cerebral vascular malformations may have only one millimeter of cerebral blood vessels. With the increase of age, the final result of cerebrovascular disease is that the longer and thinner the blood vessels are, just like the balloon is blown bigger and bigger, and various factors, such as intense activity, will burst. Many children have ruptured their cerebral vessels while playing basketball. Therefore, young people's cerebral hemorrhage is usually their own defect.
Dr Miao Zhongrong reminded:
Young people or children often have headaches, which is the most typical symptom of cerebrovascular malformation and needs to be paid attention to by parents. Then some children have epilepsy, or transient limb weakness, numbness, dizziness, and it is also recommended to go to the hospital to check whether there is a problem with cerebrovascular disease.
For adults, it is mainly to pay attention to their blood pressure. If your parents have high blood pressure, especially within three generations, or you are already suffering from high blood pressure, be sure to control your blood pressure. When you have symptoms such as transient blackness, weakness of one limb, slurred speech and splitting headache, please go to the hospital in time. After all, stroke is a disease with a high disability rate. It's better for a wolf to come than to delay his illness, don't you think?
Disclaimer: This article was originally written by Ady, and has been professionally proofread by the interviewed experts. It is forbidden to reprint and extract it without authorization, otherwise the legal responsibility will be strictly investigated! Some pictures come from the internet. For more authoritative health knowledge, please pay attention to WeChat official account: Ady reads health for you.
Interviewed experts introduced
Miao Zhongrong, director, chief physician, professor and doctoral supervisor of interventional neurology in Beijing Tiantan Hospital.
Concurrently: member of the International Stroke Association (WSO), director of the China Stroke Association, chairman of the Neurointervention Branch of the China Stroke Association, deputy director of the Cerebrovascular Disease Committee of the China Geriatrics Association, deputy director of the Department of Cerebrovascular Diseases of the China Anti-aging Society, head of the Intervention Group of the Stroke Prevention Committee of the Chinese Preventive Medical Association, vice chairman of the Neurointervention Federation of the Neurology Branch of the Chinese Medical Association, and deputy head of the Intervention Group of the Neurology Branch of the Chinese Medical Association.
Engaged in intravascular treatment of cerebrovascular diseases, organized and compiled a number of expert knowledge and 20 15 guidelines for intravascular treatment of acute ischemic stroke, and organized a number of clinical trials of ischemic cerebrovascular diseases. The first multi-center prospective controlled study of endovascular stent embolectomy in China-"Endovascular Treatment of Acute Ischemic Stroke (EAST)". 20 12 completed a randomized controlled trial of symptomatic middle cerebral artery stenosis, and the results were published in the journal of stroke. 20 15 completed a multicenter prospective registration study of symptomatic intracranial stenosis, and the results were published in the journal of stroke. In addition, he has published many academic papers in Stroke, Neurosurgery, BMJ, AJNR, JNIS and other magazines, published 3 monographs on interventional therapy of ischemic cerebrovascular disease, and published a popular science reading, Comic Stroke 1 book.
Brief introduction of the author
Lin Zi, a senior medical media person, a medical popular science writer and former director of health program of Beijing TV Station, has been deeply involved in the field of health communication for nearly ten years. On 20 15 and 10, the medical popular science column "Zilin Read Health for You" was founded. In half a year, the cumulative reading volume of major websites exceeded10 million.