A brain hemorrhage refers to bleeding in the brain. This medical condition is also known as a brain bleed or an intracranial hemorrhage. It is a medical emergency that requires immediate treatment.
Brain hemorrhages are also called cerebral hemorrhages, intracranial hemorrhages, or intracerebral hemorrhages. They account for about 13% of strokes.
Since some brain hemorrhages can be disabling or life-threatening, it’s important to get medical help fast if you think someone is having one. Here’s what you need to know about the causes, symptoms, treatments, and more.
What Happens During a Brain Hemorrhage?
When blood from trauma irritates brain tissues, it causes swelling. This is known as cerebral edema. The pooled blood collects into a mass called a hematoma. These conditions increase pressure on nearby brain tissue, and that reduces vital blood flow and kills brain cells.
Bleeding can occur inside the brain, between the brain and the membranes that cover it, between the layers of the brain’s covering or between the skull and the covering of the brain.
What Causes Bleeding in the Brain?
There are several risk factors and causes of brain hemorrhages. The most common include:
- Head trauma. Injury is the most common cause of bleeding in the brain for those younger than age 50.
- High blood pressure. This chronic condition can, over a long period of time, weaken blood vessel walls. Untreated high blood pressure is a major preventable cause of brain hemorrhages.
- Aneurysm. This is a weakening in a blood vessel wall that swells. It can burst and bleed into the brain, leading to a stroke.
- Blood vessel abnormalities. (Arteriovenous malformations) Weaknesses in the blood vessels in and around the brain may be present at birth and diagnosed only if symptoms develop.
- Amyloid angiopathy. This is an abnormality of the blood vessel walls that sometimes occurs with aging and high blood pressure. It may cause many small, unnoticed bleeds before causing a large one.
- Blood or bleeding disorders. Hemophilia and sickle cell anemia can both contribute to decreased levels of blood platelets and clotting. Blood thinners are also a risk factor.
- Liver disease. This condition is associated with increased bleeding in general.
- Brain tumors.
What are symptoms and signs of a brain hemorrhage?
Brain bleed symptoms may include:
- Sudden or severe headache
- Weakness, tingling or numbness in the arms or legs (often on one side)
- Nausea or vomiting
- Changes in vision
- Changes in balance
- Difficulty speaking or understanding speech
- Difficulty using fine motor skills
- Loss of consciousness
If you’re experiencing brain hemorrhage symptoms, be sure to call your doctor or call 911 right away.
How do doctors diagnose a brain hemorrhage?
If any kind of stroke is suspected, immediate evaluation is needed. Examination may reveal evidence of brain injury with weakness, slurred speech, and/or loss of sensations. Generally, a radiology examination is necessary, such as a computed tomography (CT) scan or magnetic resonance imaging (MRI) scan. The CT or MRI can highlight various features and location of brain bleeding. If bleeding inside of or around the brain is noted, further testing may be ordered to try to determine the cause of the bleeding. This additional testing can help to determine if abnormal blood vessels are present as well as the next step in either diagnosis or treatment. In certain situations, a spinal tap (lumbar puncture) may be required to confirm evidence of bleeding or rule out other brain problems.
What is the treatment for a brain hemorrhage?
Patients with bleeding inside of the brain must be monitored very closely. Early treatment includes stabilizing blood pressure and breathing. A breathing assist machine (ventilator) can be required to ensure that enough oxygen is supplied to the brain and other organs. Intravenous access is needed so that fluids and medications can be given to the patient, especially if the person is unconscious. Sometimes specialized monitoring of heart rhythms, blood oxygen levels, or pressure inside of the skull is needed.
After a person has been stabilized, then a determination of how to address the bleeding is made. This stabilization and decision-making process takes place very rapidly. The decision to perform surgery is based on the size and location of the hemorrhage. Not everyone with an intracranial hemorrhage needs to have surgery.
Various medications may be used to help decrease swelling around the area of the hemorrhage, to keep blood pressure at an optimal level, and to prevent seizure. If a patient is awake, pain medication may be needed.
What is the prognosis after a brain hemorrhage? Is recovery possible?
Many patients who have experienced a brain hemorrhage do survive. However, survival rates are decreased when the bleeding occurs in certain areas of the brain or if the initial bleed was very large.
If a patient survives the initial event of an intracranial hemorrhage, recovery may take many months. Over time and with extensive rehabilitation efforts, including physical, occupational, and speech therapy, patients can regain function. However, some can be left with persistent weakness or sensory problems. Other patients may have residual seizures, headaches, or memory problems.
Infants less than 32 weeks gestational age are at higher risk of developing intracranial bleeding, due to the immaturity of the blood vessels. A significant percentage of premature infants may develop some amount of intracranial hemorrhage. This can lead to hydrocephalus, or an enlargement of the fluid-filled spaces of the brain, and can be very serious. If delivery cannot be delayed, certain medications can be given to the mother in an effort to help prevent this condition.
Brain hemorrhages are life-threatening and require urgent treatment and extended rehabilitation. Some other medical conditions, such as diabetes, can increase the risk.
However, wearing protection during activities that may risk traumatic brain injury, such as cycling, as well as engaging in a healthful, active, smoke-free lifestyle can reduce the risk of a brain hemorrhage.
SHARE IN COMMENTS IF ANY CLOSE PERSON OF YOUR GONE THROUGH BRAIN HEMORRHAGE.