Brain hemorrhage (cerebral hemorrhage) caused by the rupture of blood vessel (usually a cerebral artery), leading to blood and brain damage.
Cerebral hemorrhage can be classified according to the location of the bleeding and the intensity of the organ damage. The type of hemorrhage determined by various diagnostic examinations and by observing the symptoms of the patient.
The hematoma is a blood mass that caused by damage or rupture of the blood vessels in the brain. The epidural hematoma caused by a trauma of the skull, which may lead to rupture of the meningeal artery. A localized swelling may occur as a result of blood coagulation.
If the veins below the cerebral membranes tear, a subdural hematoma is formed. This disease also be caused by a secondary trauma or a dull impact on the head. Causes for the elevation of the pressure of the brain arteries (which can rupture) are:
- Deposits of the protein amyloid in the brain,
- Arteriovenous malformations,
Bleeding in the interior of the brain tissue causes an intraparenchymatous or intra-cerebral hemorrhage, which occurs mainly in the elderly. Brain hemorrhage also affect the ventricles in the brain, which contain the brain water.
The typical cerebral hemorrhage takes place in the deeper layers, for example in the thalamus. An atypical cerebral hemorrhage is closer to the surface; it can occur in the frontal, parietal or occipital region, for example at the level of the cerebellum or the bridge.
It can occur on one side (right or left side of the brain) or on both sides.
Some common causes of brain hemorrhage are:
- Hypertension: If high blood pressure is not treated appropriately for an extended period of time, the walls of the blood vessels are weakened, which increases the risk of intra-cranial hemorrhage.
- Aneurysm: The blood vessel swells and the vessel walls are weakened. The thin walls of the aneurysm can rupture and lead to bleeding into the sub-arachnoid space or into the brain.
- Trauma: In children and generally in people under 50 years, cerebral hemorrhage is the main cause of brain hemorrhage. In the elderly, the subdural hematoma occurs most frequently due to a minor head injury.
- Genetic predisposition: The neonatal cerebral hemorrhage occurs mainly in premature babies, as the organs are not yet fully developed and the capillaries are still very fragile.
The symptoms occur only when cerebral hemorrhage affects an important part of the brain. Signs and symptoms of this dangerous disorder may vary according to the severity and localization of the bleeding. The most common symptoms include:
- Sudden and severe headache, which can last for days
- General weakness of the body or lethargy
- Sudden epileptic seizures
- Loss of consciousness
- Muscle cramps in arms or legs
- Numbness or tingling sensation
- Feeling of nausea, sometimes followed by vomiting
- Exhaustion of motor skills and trembling hands
- Loss of balance and coordination.
The diagnosis is based on the patient’s physical and neurological examination.
In order to exclude other diseases, the physician can perform a computed tomography (CT) or a magnetic resonance tomography (MRI) of the head or a lumbar puncture (removal of the brain spinal fluid in the lower back by means of a needle).
Sometimes the affected persons show normal examination results in the CT or MRT. In this case, a lumbar puncture is a compulsory procedure for diagnosing the disease.
The treatment of cerebral hemorrhage is divided into acute treatment and long-term treatment.
If brain hemorrhage caused by a hypertension, the doctor may prescribe anti-hypertensives which reduce the blood pressure and thus reduce the cerebral hemorrhage. There are many medicines that are able to dissolve blood clots that have formed due to the bleeding.
Long-term treatment begins when the person concerned has survived the critical phase. This treatment involves a mostly lengthy, neurological rehabilitation.
In newborns, there is no suitable method to prevent cerebral hemorrhage.
- Proper care of mother and child during pregnancy and after birth is important to prevent the risk of cerebral hemorrhage.
- Blood diseases such as hemophilia, blood cancer or thrombocytopenia increase the risk of bleeding.
- Preventive measures can be therapeutic methods for circulatory diseases.
- Monitoring the blood pressure is important to ensure that the blood pressure does not drastically drop or rise.
Bleeding in brain caused directly by severe brain injuries or aneurysm, the persons concerned should be careful to avoid head injuries. A sudden cerebral hemorrhage is very dangerous and lead to the death of the person concerned.