Brain Hemorrhage: Causes, Symptoms, Treatments

A brain hemorrhage is a type of stroke. It's caused by an artery in the brain bursting and causing localized bleeding in the surrounding tissues. This bleeding kills brain cells.

The Greek root for blood is hemo. Hemorrhage literally means "blood bursting forth." Brain hemorrhages are also called cerebral hemorrhages, intracranial hemorrhages, or intracerebral hemorrhages. They account for about 13% of strokes.

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 the Symptoms of Brain Bleeding?

The symptoms of a brain hemorrhage can vary. They depend on the location of the bleeding, the severity of the bleeding, and the amount of tissue affected. Symptoms tend to develop suddenly. They may progressively worsen.

If you exhibit any of the following symptoms, you may have a brain hemorrhage. This is a life-threatening condition, and you should call 911 or go to an emergency room immediately. The symptoms include:

• A sudden severe headache
• Seizures with no previous history of seizures
• Weakness in an arm or leg
• Nausea or vomiting
• Decreased alertness; lethargy
• Changes in vision
• Tingling or numbness
• Difficulty speaking or understanding speech
• Difficulty swallowing
• Difficulty writing or reading
• Loss of fine motor skills, such as hand tremors
• Loss of coordination
• Loss of balance
• An abnormal sense of taste
• Loss of consciousness

Keep in mind that many of these symptoms are often caused by conditions other than brain hemorrhages.

How Is a Brain Hemorrhage Treated?

Once you see a doctor, they can determine which part of the brain is affected based on your symptoms.

Doctors may run a variety of imaging tests, such as a CT scan, which can reveal internal bleeding or blood accumulation, or an MRI. A neurological exam or eye exam, which can show swelling of the optic nerve, may also be performed. A lumbar puncture (spinal tap) is usually not performed, as it may be dangerous and make things worse.

Treatment for bleeding in the brain depends on the location, cause, and extent of the hemorrhage. Surgery may be needed to alleviate swelling and prevent bleeding. Certain medications may also be prescribed. These include painkillers, corticosteroids, or osmotics to reduce swelling, and anticonvulsants to control seizures.

Can People Recover From Brain Hemorrhages, and Are There Possible Complications?

How well a patient responds to a brain hemorrhage depends on the size of the hemorrhage and the amount of swelling.

Some patients recover completely. Possible complications include stroke, loss of brain function, seizures, or side effects from medications or treatments. Death is possible, and may quickly occur despite prompt medical treatment.

Can Brain Hemorrhages Be Prevented?

Because the majority of brain hemorrhages are associated with specific risk factors, you can minimize your risk in the following ways:

• Treat high blood pressure. Studies show that 80% of cerebral hemorrhage patients have a history of high blood pressure. The single most important thing you can do is control yours through diet, exercise, and medication.
• Don’t smoke.
• Don’t use drugs. Cocaine, for example, can increase the risk of bleeding in the brain.
• Drive carefully, and wear your seat belt.
• If you ride a motorcycle, always wear a helmet.
• Investigate corrective surgery. If you suffer from abnormalities, such as aneurysms, surgery may help to prevent future bleeding.
• Be careful with Coumadin. If you take this blood-thinning drug, also called warfarin, follow up regularly with your doctor to make sure your blood levels are in the correct range.

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