Cerebral Hemorrhage

A cerebral hemorrhage occurs when a blood vessel in the head bursts, leaking blood into the surrounding area. The bleeding can cause swelling and increased pressure inside the skull, resulting in brain damage or even death.

Overview

Types

There are four types of cerebral hemorrhage, depending on where the bleeding occurs:

  • Epidural hemorrhage occurs when there is bleeding between the skull and the covering of the brain. 
  • Intracerebral hemorrhage occurs when there is bleeding around or within the brain. 
  • Subarachnoid hemorrhage occurs when there is bleeding between the brain and the membranes that cover the brain. 
  • Subdural hemorrhage occurs when there is bleeding on the brain’s surface (meninges). 

Causes

There are many reasons for a cerebral hemorrhage. For people under 50, the most common cause is a head injury. Other causes include: 

  • A build-up of protein inside the arteries that supply blood to the brain (known as cerebral amyloid angiopathy)
  • A blood clot blocking an artery in the brain
  • A defect in the arteries or veins in or around the brain (known as arteriovenous malformation, or AVM)
  • A bleeding tumor
  • Taking blood thinners or anti-clotting drugs
  • Uncontrolled high blood pressure

Symptoms

Cerebral hemorrhage symptoms come on quickly. They include:

  • Loss of consciousness
  • Confusion
  • Sudden, severe headache
  • Blindness 
  • Nausea or vomiting
  • Numbness, weakness or paralysis
  • Seizures
  • A stiff neck
  • Inability to speak

Diagnosis

To confirm a cerebral hemorrhage, your doctor will order one of the following tests:

  • Cerebrospinal fluid exam
  • An MRI or CT scan 
  • A lumbar puncture (also known as a spinal tap)

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Treatment Options

Treatment depends on several factors: a person’s overall health, the cause and location of the bleeding and how long the bleeding has been going on. 

Treatment options include: 

  • Brain mapping surgery: This approach allows your surgeon to remove the tumor through a dime-sized narrow channel, or port. Compared with traditional open surgery, it typically causes less scarring, fewer side effects and fewer complications, as well as a quicker recovery.
  • Surgery: In some cases, traditional surgery may be needed to drain the blood or repair damaged blood vessels.
  • Catheter: A long, thin tube is threaded through blood vessels until it reaches the affected area.
  • Medications: If the bleeding is caught early, blood clotting drugs may be able to slow it down; other medications may be prescribed to reduce high blood pressure or help with symptoms like seizures or headaches. 
  • Physical, occupational and speech therapies: These may help a patient regain brain functions (such as the ability to speak) that may have been affected by the bleeding.

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