Cerebral hemorrhage (apoplexy)

Etiology. Cerebral hemorrhage is most likely to occur in persons who have hypertension and arteriosclerosis. In fact, it is one of the serious complications of hypertension. Most cases occur after the age of fifty.

Symptoms and signs. The onset is usually sudden with the development of severe headache, paralysis or unconsciousness within a few minutes. Some cases, however, are marked by a more gradual development during which period the patient complains of dizziness, visual disturbances, headache and perhaps mental aberrations.

For some unexplained reasons the branches of the sylvian arteries — those which supply the motor area of the brain — are the ones most commonly affected and consequently paralyses are commonly observed.

In the more serious cases unconsciousness occurs within a relatively short period after the onset, and by the time the physician is called the patient is in a deep stupor. A variety of neurological signs may be evident, depending of course upon the location of the hemorrhage. There is often a deviation of the eyes which usually "look toward the affected side." The pupils are fixed; there may be evident paralysis of the facial muscles on the affected side.

During the early stages the limbs may be flaccid, but, later, evidence of upper motor neuron involvement becomes evident with the increasing muscle tone, hyperactive reflexes and presence of pathologic reflexes (Babinsky, Hoffman, and others). Ankle clonus may be evident. Hemorrhage into parts of the brain other than the motor area may produce a diversity of symptoms and findings.

Diagnosis. In severe cases there is usually little difficulty with the diagnosis — the presence of hypertension, the suddenness of the onset, the development of paralysis being found in combination. Examination of the spinal fluid reveals an increase of the pressure and in most instances there will be gross blood.

Prognosis. The prognosis of cerebral hemorrhage is grave. It is poorest in those cases in which profound coma persists for twenty-four hours or longer and in those patients who develop a high fever. If consciousness returns, the patient stands a good chance of recovery, but may suffer from subsequent attacks at any time. Paralyses often improve after one or two weeks as the edema of the brain subsides. Paralyses lasting two weeks or longer are likely to be more or less permanent.

Treatment. The treatment of cerebral hemorrhage is largely supportive. Close nursing attention to prevent strangulation and aspiration is important. In those cases in which the patient recovers from the initial acute symptoms, every effort should be directed toward the maintenance of muscle function by massage and passive exercise.

POST-TEXT ASSIGNMENTS

Exercise 7. Answer the questions:

What are the causes of apoplexy?

At what age is apoplexy likely to occur?

Is the onset of the disease sudden or gradual?

Why is paralysis most commonly observed?

What eye signs are evident in cerebral hemorrhage?

What is the prognosis of the disease?

What does treatment consist of?

Exercise 8. Find synonyms to the following words in the text:

Bleeding, giddiness, case, investigation, extremities, constant, data, convalescence, elevation, deep

Exercise 9. Find English equivalents to the following word combinations:

Серьезное осложнение, постепенное развитие, зрительные расстройства, мышечный тонус, пораженная сторона, локализация кровоизлияния, лицевые мышцы, относительно короткий период, вовлечение верхнего моторного нейрона, сверхактивные рефлексы, спинномозговая жидкость, первоначальные острые симптомы, глубокая кома, массивное кровотечение, последующие приступы, внезапность начала.

Exercise 10. Insert prepositions:

There may be evident paralysis … the facial muscles … affected area.

In serious cases unconsciousness occurs … a relatively short period.

… the early stages the limbs may be flaccid.

The prognosis is poor …cases when profound coma persists … twenty-four hours or longer.

Some cases of apoplexy are marked … a more gradual development.

Neurological signs may depend … the location … hemorrhage.

… severe cases there is usually little difficulty … the diagnosis.

Exercise 11. Translate the sentences with the Complex subject (revision)

1. After vitamin injections some patients seem to have improved.

2. He was known to have had a hernia for many years.

3. Precise monitoring of serum electrolytes would appear essential before and during antiarrhythmic drug therapy.

4. Coronary patients have now been established to be at increased risk of cardiac mortality.

5. Injuries are most likely to have occurred in children.

6. The number of drugs are known to have been available for the treatment of cardiac failures.

7. The cell happened to have divided during the experiment.

Exercise 12. Translate the following sentences using the Complex subject:

1. Лимфоциты, как известно, регулируют иммунный ответ.

2. Ферменты, по-видимому, очень лабильны.

3. Очевидно, онкологи научатся лечить рак.

4. Сообщили, что ученые Канады изолировали ген, определяющий пол ребенка.

5. Обнаружили, что это явление имеет широкое распространение.

6. Известно, что гипертония и ишемическая болезнь сердца составляют большой процент заболеваемости.

7. Сообщалось, что операции по вживлению искусственного сердца человеку проводятся в США и в нашей стране.

8. Известно, что операции по вживлению искусственного сердца сложны и многоплановы.

9. Известно, что созданы портативные дефибрилляторы.

10. Результаты оказались удовлетворительными.

Exercise 13. What do you mean by

spinal fluid

headache

paralysis

Exercise 14. SYMPTOMS.Choose the correct answers.

1. She has been working so hard she feels quite....

a) careful b) dull c) exhausted d) wasted

2. The dog was in a terrible... when we found it.

a) condition b) danger c) illness d) sickness

3. His illness made him... of concentration.

a) incapable b) incompetent c) powerless d) unable

4. I felt a sharp... when I put my hand in the boiling water.

a) ache b) harm c) pain d) suffer

5. If you have got measles, your body is covered in....

a) blots b) dots c) freckles d) spots

6. There is a small hard... on my wrist. I think I'd better see the doctor.

a) bruise b) lump c) rash d) swelling

7. I have a bad cold, and have lost all... of smell.

a) degree b) scent c) sense d) skill

8 He... from rheumatism.

a) hurts b) pains c) suffers d) troubles

9. Women seem able to... pain better than men.

a) bear b) carry c) support d) wear

10. I couldn't go to the party because of a... cold.

a) fast b) hurried c) sudden d) surprising

11.I have a... headache.

a) burning b) raving c) spitting d) splitting

12. Her sister's... kept me awake for half the night.

a) blowing b) coughing c) flowing d) swallowing

13. His stomach began to... because of the bad food he had eaten.

a) ache b) be hurt c) harm d) pain

14. You can die from breathing the... from a car engine for too long.

a) air b) fumes c) smoke d) steam

15. He says he has got … in his stomach.

a) aches b) hurt c) pains d) suffering.

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