Treatment Strategies for Patients with Long Term Hemodialysis Complicated with Intracranial Hemorrhage

Objective To explore treatment strategies for patients with chronic hemodialysis complicated with intracranial hemorrhage.Methods Retrospectively analyzing the clinical data of 41 cases with hemodialysis complicated with intracranial hemorrhage. Analyzing the relationship between the prognosis and the site,volume of bleeding and treatment options. Results 33 cases used conservative treatment method. 20 cases were improved,and 13 cases died. The amount of bleeding was less than 40 mL in the improved patients. Among dead cases,2 dead cases had brain stem hemorrhage,and others bleeding volume were greater than 40 mL. Hematoma volume of 8 patients underwent surgical operation was more than 40 mL,with the craniotomy evacuation of hematoma in 5 cases. Hematoma volume was more than60 mL. 4 patients died. 1 case survived. In 3 cases with trepanation and drainage,2 cases survived,and 1 cases died. Conclusion Medical treatment can have a relatively good prognosis in the patients of supratentorial intracranial bleeding amount less than 40 mL,small amount of the cerebellum and even brainstem hemorrhage. Patients with the bleeding volume above 40 mL,or obstructive hydrocephalus caused by intraventricular hemorrhage should get operation theoretically; but because of the difficulty of hemostasis,postoperative hemorrhage and severe cerebral edema causing death of patients,the operation treatment must be done carefully.