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В результате кровоизлияния образуется гематома (скопление крови), которая давит на окружающую ткань и вызывает её повреждение [3](https://locmr.ru/articles/gemorragicheskiy-insult/)[7](https://ProBolezny.ru/insult-gemorragicheskiy/). \n\nВыделяют несколько разновидностей геморрагического инсульта в зависимости от локализации кровоизлияния [1](https://orbifond.ru/about-stroke/hemorrhagic-stroke/): \n* **Внутримозговое** — кровь изливается непосредственно в мозговую ткань [5](https://pharmznanie.ru/article/chto-takoye-gemorragicheskiy-insult). \n* **Субарахноидальное** — кровь попадает в пространство между мозгом и паутинной оболочкой [5](https://pharmznanie.ru/article/chto-takoye-gemorragicheskiy-insult).\n\n\n\n## Причины\nНекоторые факторы риска геморрагического инсульта: \n* **Артериальная гипертензия** (повышенное артериальное давление) — высокое давление увеличивает нагрузку на стенки артерий, что со временем может привести к их ослаблению и разрыву [5](https://pharmznanie.ru/article/chto-takoye-gemorragicheskiy-insult)[7](https://ProBolezny.ru/insult-gemorragicheskiy/). \n* **Патологии сосудистой стенки**, например аневризма — выпячивание стенки сосуда из-за её истончения [7](https://ProBolezny.ru/insult-gemorragicheskiy/). \n* **Заболевания крови**, связанные с нарушением свёртываемости [12](https://locmr.ru/articles/gemorragicheskiy-insult/?lang=ru).\n\n## Симптомы\nНекоторые симптомы геморрагического инсульта: \n* **Внезапная, интенсивная головная боль** — часто пациенты описывают её как «взрыв» в голове [5](https://pharmznanie.ru/article/chto-takoye-gemorragicheskiy-insult). \n* **Тошнота и рвота** — связаны с повышением внутричерепного давления и воздействием на центры рвоты в головном мозге [5](https://pharmznanie.ru/article/chto-takoye-gemorragicheskiy-insult). \n* **Потеря сознания** или нарушение сознания — возникают из-за сдавления и повреждения мозговых структур кровоизлиянием [5](https://pharmznanie.ru/article/chto-takoye-gemorragicheskiy-insult). \n* **Неврологические дефициты**: внезапная слабость или паралич одной стороны тела, проблемы с речью, затруднения с глотанием и нарушение зрения [5](https://pharmznanie.ru/article/chto-takoye-gemorragicheskiy-insult). Эти симптомы зависят от области мозга, в которой произошло кровоизлияние [5](https://pharmznanie.ru/article/chto-takoye-gemorragicheskiy-insult).\n\n## Диагностика\nДиагностические мероприятия проводит врач-невролог [12](https://locmr.ru/articles/gemorragicheskiy-insult/?lang=ru). Некоторые методы диагностики: \n* **Неврологический осмотр** — оценивает клинические симптомы, состояние сознания, чувствительности, мышечного тонуса, двигательных и речевых нарушений, когнитивных функций [12](https://locmr.ru/articles/gemorragicheskiy-insult/?lang=ru). \n* **Компьютерная и магнитно-резонансная томография** — позволяют установить локализацию и размер гематомы, степень отёка и распространённости кровоизлияния [12](https://locmr.ru/articles/gemorragicheskiy-insult/?lang=ru). \n* **Эхоэнцефалография** — помогает определить смещение головного мозга относительно костей черепа, возникающее вследствие давления гематомы [12](https://locmr.ru/articles/gemorragicheskiy-insult/?lang=ru).\n\n## Лечение\nЛечение геморрагического инсульта может быть консервативным или хирургическим [12](https://locmr.ru/articles/gemorragicheskiy-insult/?lang=ru). Решение о выборе способа принимает врач-невролог после детального обследования [12](https://locmr.ru/articles/gemorragicheskiy-insult/?lang=ru). \n\n**Консервативное лечение** включает медикаментозную терапию — лекарственные препараты подбирает лечащий врач с учётом причины кровоизлияния, показателей кровяного давления, общего состояния пациента [12](https://locmr.ru/articles/gemorragicheskiy-insult/?lang=ru). \n\n**Хирургическое лечение** — удаление образовавшейся гематомы [13](https://unclinic.ru/lechenie-gemorragicheskogo-insulta/). Показания к операции зависят от того, где именно расположена гематома [13](https://unclinic.ru/lechenie-gemorragicheskogo-insulta/). 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