Brain hemorrhage

The brain is enclosed inside of the skull. If there is any leaking blood, the brain can become compressed and can damage areas in the brain. Bleeding caused by a blood vessel in the brain that has leaked or burst is called a hemorrhagic stroke.

With enough bleeding, the brain can become so compressed that oxygen-rich blood is unable to flow into the brain tissue. The lack of oxygen can lead to brain swelling, referred to as cerebral edema. The pooled blood collects into a mass known as a hematoma. The extra pressure created as a result of the reduced oxygen can kill brain cells.

Causes and symptoms

• head trauma or injuries
• cerebral aneurysm, a weak area in an artery in the brain
• high blood pressure
• blood vessel abnormalities
• blood or bleeding disorders
• liver disease
• brain tumor
• drug abuse

A brain hemorrhage can cause a variety of different symptoms. These symptoms can include sudden tingling, weakness, numbness or paralysis of the face, arm, or leg. This is most likely to occur on just one side of the body.

Other brain hemorrhage symptoms include:

• sudden, severe headache
• difficulty swallowing
• problems with vision
• loss of balance or coordination
• confusion or difficulty understanding
• difficulty talking or slurred speech
• stupor, lethargy, or unconsciousness
• seizures

Diagnosis and treatment

There are a few types of brain hemorrhages. The type depends on the location of the bleeding:

• intracerebral hemorrhage – bleeding that occurs inside of the brain
• subarachnoid hemorrhage – bleeding between the brain and the membranes that cover it
• subdural hemorrhage – below the inner layer of the dura and above the brain
• epidural hemorrhage – bleeding between the skull and the brain

Diagnosing a brain hemorrhage can be difficult because some patients do not always show physical signs. Doctors must carry out tests to see the exact location of the bleeding in the brain.

Testing options include:

• CT (computed topography)
• MRI (magnetic resonance imaging)
• lumbar puncture (spinal tap)
• X-rays of the brain after a dye is injected (cerebral angiography)

Surgery may be needed to treat the brain hemorrhage if the situation is severe. It may be needed for doctors to relieve some of the pressure on the brain.

A hemorrhage caused by a burst cerebral aneurysm requires the clipping of the artery through a surgical procedure where part of the skull is removed. This procedure is called a craniotomy.

Other treatment options include anti-anxiety drugs, anti-epileptic drugs, and other medications to control symptoms such as severe headaches.

Complications after a brain hemorrhage

Complications can arise after a brain hemorrhage. The bleeding prevents the nerve cells from communicating with the parts of the body and the functions they control. Problems such as a loss of memory, speech, or movement in the affected area are common.

Depending on the location and the damage that occurs, there may be some lasting complications. These complications can include:

• paralysis
• numbness or weakness in part of the body
• difficulty swallowing
• vision loss
• inability to speak or understand words
• confusion or memory loss
• personality change or emotional problems

It is possible to recover from a brain hemorrhage, but proper treatment is crucial. Rehabilitation is typically needed to improve a person’s condition.

Rehabilitation treatment includes:

• physical therapy
• speech therapy
• occupational therapy
• lifestyle changes to reduce risk of another hemorrhage

Age

The effects of brain hemorrhages vary within different age groups. Brain hemorrhages are most likely to occur in older adults.

Most of the intracerebral hemorrhages that suddenly occur in children are due to abnormalities in the blood vessels. Other possible causes include blood diseases, brain tumors, septicemia, or drug abuse.

According to one study, trauma was the most frequent cause of brain hemorrhage followed by bleeding disorders.

In infants and children, brain hemorrhages are not as likely but can occur. In infants, brain hemorrhage can be due to a birth injury, such as being dropped just after delivery or from blunt force trauma to the pregnant belly.

Symptoms, as well as some of the treatment options, are very similar in adults and children. Treatment in children depends on the location of the hemorrhage as well as the severity of the case.

According to the Cleveland Clinic, stroke is the leading cause of disability and the fifth-leading cause of death in the United States. Brain hemorrhages account for approximately 10 percent of all strokes in the U.S.

Hemorrhages are more common in older adults, but they can also occur in children. According to the National Stroke Association, a stroke happens in about 1 in 4,000 live births. They are slightly more common in children under age 2.

Children generally recover better than adults from brain hemorrhages because their brain is still developing.

Prevention

Since many brain hemorrhages are caused by injuries, it is important to take safety precautions such as wearing a helmet while riding a bicycle or motorcycle.

According to the American Association of Neurological Surgeons, about 1.7 million cases of traumatic brain injury occur in the U.S. every year. About 5.3 million people live with a disability due to their injury.

Many brain hemorrhages are due to brain injuries. As a result, it is important that people protect their brains. Wearing seat belts in cars or helmets when riding bikes or motorcycles are easy ways to protect the head area.

People who have a brain hemorrhage or a stroke are more likely to have another one in the future. Making lifestyle changes can help an individual to lower their risk or prevent an event from happening.