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APOPLEXY. (Cerebral Hemorrhage). (Brain Hemorrhage). Causes

Category: Diseases of The Nervous System

(hemorrhage) into the brain substance is almost always due to an affection
of the walls of the large or small arteries of the brain, producing
rupture and subsequent bleeding. Persons of fifty or over are more subject
to it, and it is more common in men than in women. Any disease that will
cause degeneration of the arteries, helps to cause it, such as nephritis,
rheumatism, syphilis, gout and alcoholism. Nephritis is one of the most
certain causes, because arterio-sclerosis (hardening and decaying of the
walls of the arteries) and hypertrophy of the heart are associated with
nephritis, etc.

Direct Causes. Straining at stool, heavy lifting, anger, rage, fright,
etc.; paroxysm of whooping-cough or convulsions may cause it in children.

Symptoms. Sometimes the patient experiences headache, dizziness, paleness
or flushing of the face, fullness in the head, ringing in the ears, etc.,
temporary attacks of numbness or peculiar tingling in one-half of the
body. When the bleeding takes place there is usually loss of
consciousness. In the attack:--If the bleeding is extensive the patient
falls suddenly into coma, and this may soon prove fatal. If the bleeding
is slight at first and gradually increases, the patient is delirious at
first, then one arm, then one side, and finally the whole body may become
paralyzed, and unconsciousness, and even death may come from the paralysis
of the heart and breathing nerve centers. In many cases the patient falls
unconscious without previous warning. The face is red, the eyes injected,
the lips are blue, the pulse is full and slow, and the breathing is slow
and deep. The head and eyes may be strongly turned to the injured side.
The pupils may be unequal. The paralysis may not be noticed while the
patient is unconscious and is quiet. The urine and the bowels contents may
pass involuntarily or the urine may be retained. Sometimes when the case
is very grave the patient does not awake from his deep sleep (coma); the
pulse becomes very feeble, respiration becomes changed, mucus collects in
the throat, and death may occur in a few hours or days. In other cases the
clot in the brain is gradually absorbed, and the patient slowly returns to
consciousness. Sometimes relapses occur. In mild cases instead of deep
coma, there may be only headache, faintness, nausea and vomiting.

Subsequent Symptoms. When the patient improves, consciousness returns,
but there remains a half-side paralysis, hemiplegia, on the side and
opposite to that of the seat of the injury in the brain. It may not take
in the whole side, only a part. The gait is peculiar. In walking the
patient supports the paralyzed arm. In many cases the paralyzed parts
gradually regain their functions in a few weeks, but not always complete.
The leg improves more than the arm. There is danger of other attacks. When
the sleep (coma) is very deep, the breathing is embarrassed, with vomiting
and prolonged half-consciousness and extension and complete paralysis,
the danger to life is great.

What can I do at once? Loosen the clothing around the neck and waist.
Raise the head and shoulders and put cold to the head (ice bag if you have
it) and warmth to the feet, legs and hands. Watch the bladder closely. The
urine must be drawn frequently in this disease, especially if there is
much paralysis. It may dribble away, but that is not enough. Look out for
bed sores, especially if the sickness is a long one.

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