What are the most common bleeding sites for intracerebral hemorrhage?

Answer] Wanton Sense: c

Test Center] The most common bleeding vessel for intracerebral hemorrhage.

Analysis] The most common fissure hemorrhagic vessel of cerebral hemorrhage is the beticular artery of the middle cerebral artery, because the artery is the perforating branch of the deep brain tissue, which is often subjected to high pressure, and has special anatomical characteristics, that is, it is at right angles to the main trunk, so it can withstand large perfusion pressure, which can form microaneurysms, which are easy to rupture and cause bleeding, and other arteries have less bleeding.

a.Dentate nucleus artery of the cerebellum.

b.The lenticular artery of the middle cerebral artery.

c.The veins are high and contain the anterior artery.

d.Paramedian artery of the basal benevo silver artery.

e.Anterior communicating artery.

Correct answer: B

The clinical manifestations of intracerebral hemorrhage are briefly described.

A:(1) Basal ganglia hemorrhage. The putamen nucleus is the most common site of bleeding and often affects the internal capsule.

In addition to whole-brain symptoms, there may be binocular gaze to the side of the lesion, hemiplegia on the opposite side of the lesion, hemisensory impairment, and homotropic hemianopia (triple hemicyclopacy). Dominant hemisphere involvement may have aphasia.

2) Lobar hemorrhage. Common causes include cerebral arteriovenous malformations. The parietal lobe is the most common site of bleeding.

Clinically, it can manifest as headache, vomiting, etc., seizures are more common than bleeding in other parts, and coma is less common. Depending on the lobes involved. Focal localization symptoms are present.

3) Pontine hemorrhage. When bleeding is low, the patient may be conscious, have cross-paralysis, and fix both eyes on the paralyzed limb. When bleeding profusely (>5m1), the hematoma spreads to both pons, and the patient may suddenly become comatose, with flaccid paralysis of the limbs, bilateral pinpoint pupils, central hyperthermia, dyspnea, and death within 48 hours.

4) Cerebellar hemorrhage. The onset is sudden, dizziness and ataxia are obvious, and there may be occipital headache and vomiting. Heavy bleeding (>15ml), especially vermisite hemorrhage, the patient quickly becomes unconscious, bilateral pupil constriction, irregular breathing, and even death due to foramen magnum.

5) Ventricular hemorrhage. Minor bleeding presents with headache, vomiting, meningeal ** signs, general consciousness, and a good prognosis. Heavy hemorrhage is followed by rapid coma, vomiting, quadriplegia, extremely narrowed pupils, positive pathological reflexes, irregular breathing, central hyperthermia, poor prognosis, and rapid death.

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Answer]: B Intracerebral hemorrhage is the most serious and often fatal complication of hypertension, and the reorbidence is mostly massive hemorrhage, which often occurs in the basal nucleus and internal capsule, followed by the white matter of the brain, and about 15% occurs in the brainstem. The reason why intracerebral hemorrhage is more common in the basal nucleus region is that the lenticular artery of the blood in this area branches out at right angles from the middle cerebral artery, and is directly impacted and pulled by the blood flow with high pressure in the middle cerebral artery.

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