What to know about brain hemorrhage
The skull surrounds the brain, and any leaking blood from a hemorrhage can cause compression and damage to the brain tissues.
If a blood vessel in the brain leaks or bursts and causes bleeding, a hemorrhagic stroke occurs.
Compression from excessive bleeding may be so severe that oxygen rich blood is unable to flow to the brain tissue. A lack of oxygen in the brain can lead to swelling, or cerebral edema.
Pooled blood from a bleed can also collect into a mass known as a hematoma. The extra pressure of this can prevent oxygen from reaching brain cells, which can result in their death.
In this article, learn more about brain hemorrhage, its causes, how to recognize when one is occurring, and what to do.
Age is a primary risk factor for brain hemorrhage.
Several factors can lead to a brain hemorrhage. These factors include:
- head trauma or injury
- cerebral aneurysm, or a weakened bulge in a brain artery
- extremely high blood pressure
- blood vessel anomalies
- blood or bleeding disorders
- liver disease
- brain tumor
- consumption of illicit drugs
The effects of a brain hemorrhage 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 anomalies in the blood vessels. Other possible causes include blood diseases, brain tumors, septicemia, or the use of alcohol or illicit drugs.
In infants, a brain hemorrhage can occur due to a birth injury or blunt force trauma to a woman's abdomen when she is pregnant.
Symptoms and 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.
Stroke is the fifth leading cause of death in the United States, according to the Centers for Disease Control and Prevention (CDC).
Hemorrhages are more common in older adults, but they may 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 2 years of age.
Children typically recover from brain hemorrhages with better outcomes than adults as a child's brain is still developing.
A brain hemorrhage can cause a range of different symptoms. These symptoms may include sudden tingling, weakness, numbness, or paralysis of the face, arm, or leg. This is most likely to occur on one side of the body only.
Other 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
It is essential to recognize these symptoms quickly to allow treatment to start as soon as possible.
Physical therapy can be essential for recovering from some effects of a brain hemorrhage.
Complications often arise from a brain hemorrhage. The bleeding prevents the nerve cells from communicating with other parts of the body and resuming normal function.
Common problems after a brain hemorrhage include movement, speech, or memory issues.
Depending on the location of a hemorrhage and the damage that occurs, some complications may be permanent. These might include:
- numbness or weakness in part of the body
- difficulty swallowing, or dysphagia
- vision loss
- reduced ability to speak or understand words
- confusion or memory loss
- personality change or emotional problems
There are several types of brain hemorrhages. The type depends on the location of the bleeding:
- Intracerebral hemorrhage: This type of bleeding occurs inside the brain.
- Subarachnoid hemorrhage: This bleeding occurs between the brain and the membranes that cover it.
- Subdural hemorrhage: This type happens below the inner layer of the dura and above the brain.
- Epidural hemorrhage: This is when a bleed develops between the skull and the brain.
All types of brain hemorrhage can pose a serious risk to health.
Diagnosing a brain hemorrhage can be difficult as some people do not show any physical signs. Doctors need to do tests to find the exact location of the bleeding in the brain.
Testing options include:
- CT or MRI scan.
- Lumbar puncture, or spinal tap, where a doctor removes spinal fluid through a hollow needle for testing.
- Cerebral angiography where a doctor injects a dye and then takes X-ray images of the brain, with the dye highlighting abnormally shaped blood vessels in or near the brain.
Surgery may be necessary to treat a severe brain hemorrhage. Surgeons may operate to relieve some of the pressure on the brain.
If a burst cerebral aneurysm causes a hemorrhage, a surgeon may remove part of the skull and clip the artery. This procedure is called a craniotomy.
Other treatment options include anti-anxiety drugs, anti-epileptic drugs, and other medications to control symptoms, such as seizures and severe headaches.
People can recover from a brain hemorrhage, although it is vital that they receive the correct treatment as soon as possible. Rehabilitation can help an individual adjust to life after a brain hemorrhage.
Rehabilitation treatment includes:
- physical therapy
- speech therapy
- occupational therapy
- lifestyle changes to limit the risk of another hemorrhage
Wearing a cycle helmet can help a person prevent traumatic brain injury.
According to the American Association of Neurological Surgeons, about 1.7 million traumatic brain injuries occur every year in the U.S. About 5.3 million people have a disability due to a previous brain injury.
It is important that people protect themselves against the risk of traumatic brain injury. Wearing seatbelts in cars or helmets when riding bikes or motorcycles are easy ways to protect the head and brain.
People who have a brain hemorrhage or a stroke have a 25% chance of another one in the future.
Making lifestyle changes can help an individual to reduce their risk or prevent a cerebrovascular event.
People with high blood pressure need to receive regular checkups and take steps to lower their blood pressure. There is a range of home blood pressure monitors available for purchase online.
It is also important to avoid smoking, which is a significant risk factor for stroke. The toxins in tobacco damage the cardiovascular system and can lead to plaque buildup in the arteries, making them narrower and more at risk of stroke.
People with diabetes need to make sure that they keep blood sugar levels under control. Many people with diabetes also have high blood pressure, high cholesterol, and may be overweight, all of which are risk factors for stroke.
Some of the most significant changes that can help reduce the risk of brain hemorrhages involve diet and exercise.
Individuals should include foods in the diet that improve heart and brain health, such as the National Heart, Lung, and Blood Institute approved DASH diet.
Excess body weight can lead to raised blood pressure, diabetes, heart disease, and stroke. People can try to get moving and stay active as physical activity not only helps to shift unwanted weight but can also contribute to lowering the risk of stroke.
The American Heart Association (AHA) recommend 150 minutes of moderate to intense exercise every week.
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.
Can a brain hemorrhage cause immediate death?
A brain hemorrhage can cause death within 12–24 hours if the bleeding is extensive and rapid.Heidi Moawad, MD Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.