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

Categories: Diseases of The Nervous System

Bleeding
(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.