Dorsch N W
Westmead Hospital, Sydney.
Aust Fam Physician. 1997 Oct;26(10):1145-50.
A proportion of strokes are due to intracranial haemorrhage. Their characteristics and treatment are different from ischaemic stroke-surgery is often necessary and thrombolytic or anticoagulant treatment contraindicated. Most intracerebral haematomas (ICH) are hypertensive in origin. Small haematomas are treated with blood pressure control and rehabilitation. Larger ones often need surgery. Treatment must be tailored to the patient's circumstances, taking into account age, general and neurological health, location of haematoma etc. Subarachnoid haemorrhage (SAH) affects younger people and is classically due to aneurysm rupture, requiring urgent neurosurgical referral. Another cause is arteriovenous malformations (AVM), also treated surgically. A major problem is failure to diagnose less severe bleeds, which often precede major haemorrhages.
一部分中风是由颅内出血引起的。它们的特征和治疗方法与缺血性中风不同——通常需要进行手术，溶栓或抗凝治疗是禁忌的。大多数脑内血肿（ICH）起源于高血压。小血肿通过控制血压和康复治疗。较大的血肿通常需要手术。治疗必须根据患者的情况进行调整，要考虑年龄、总体健康状况和神经健康状况、血肿位置等因素。蛛网膜下腔出血（SAH）影响较年轻的人群，典型的病因是动脉瘤破裂，需要紧急转诊神经外科。另一个病因是动静脉畸形（AVM），也通过手术治疗。一个主要问题是未能诊断出不太严重的出血，而这些出血往往先于大出血发生。
