How to distinguish cerebral hemorrhage from cerebral infarction?

Cerebral hemorrhage and cerebral infarction are different in nature and treatment methods, so it is necessary to make a clear diagnosis as soon as possible. In the absence of CT or MRI examination, the following differentiation can be made: ① Patients with cerebral hemorrhage have a history of hypertension and cerebral arteriosclerosis, and patients with cerebral infarction have a history of transient ischemic attack or heart disease. ② Cerebral hemorrhage usually occurs when you are emotional or exert yourself, while cerebral infarction usually occurs at quiet rest. ③ The onset of cerebral hemorrhage is acute and rapid, often reaching its peak within a few hours, without any warning before the onset. However, the progress of cerebral infarction is slow, which often worsens after 1 ~ 2 days, and there is often a history of transient ischemic attack before the onset.

④ Patients with cerebral hemorrhage often have symptoms of increased intracranial pressure, such as headache, vomiting, stiff neck, hypertension and serious disturbance of consciousness. At the onset of cerebral infarction, the blood pressure was normal, and there were no symptoms such as headache and vomiting, and the consciousness was clear. ⑤ Cerebrospinal fluid pressure in patients with cerebral hemorrhage is high, mostly bloody, while that in patients with cerebral infarction is low, clear and bloodless. ⑥ Central respiratory disorder is common in patients with cerebral hemorrhage, and the pupils are often asymmetrical, or both pupils are narrowed, and the eyeballs float in the same direction.

Central respiratory disorder is rare in patients with cerebral infarction, the pupils are symmetrical on both sides, and the eyeball rarely appears deviation and floating.

Of course, individual patients with mild cerebral hemorrhage have mild clinical symptoms, which are similar to cerebral infarction and difficult to distinguish. However, patients with large-scale cerebral infarction are similar to cerebral hemorrhage when their intracranial pressure increases and their consciousness is disturbed, which is difficult to distinguish clinically. Do a CT scan as soon as possible. The CT findings of cerebral hemorrhage are high-density shadows, while cerebral infarction is low-density shadows, which are completely different.