Definition and Overview

Brain hemorrhage refers to the bleeding of the brain and surrounding areas.

The brain is part of the central nervous system, which is composed of the spinal cord. It is one of the most integral parts of the body as it serves as the command center. It works with various nerves to receive and send messages to different body parts, ultimately telling them what to do and how to do it.

The brain itself is a very soft and delicate material and is composed of different parts. The biggest section is dominated by the cerebrum, which controls speech, memory, and emotion. There is also the brain stem, which plays a critical role during stressful situations. When a person is stressed, it goes into a fight-or-flight mode, which is regulated by this stem. It is also related to the control of blood pressure and breathing. The cerebellum is the one that takes care of movements, balance, and interpretation of information fed by different senses.

The brain, on its own, is susceptible to damage and bleeding. However, it is well protected. It is covered by different layers such as the dura mater and the cerebrospinal fluid, which is also present in the spinal cord. Outside, the skull offers protection as it’s made of different types of linked bones.

Nevertheless, many factors can still contribute to the bleeding of the brain and the surrounding areas. If the bleeding becomes uncontrolled, it can cause the death of the brain cells and, in the end, the cessation of many of the body’s functions. Sometimes it can lead to temporary or permanent disability as well as the loss of certain functions such as motor skills.

Causes of Condition

One of the biggest causes of brain hemorrhage is hypertension, which is also referred to as high blood pressure. The heart pumps blood through the various blood vessels such as the arteries to deliver oxygen and other nutrients to the cells and tissues. But for the blood to flow, it needs pressure as it passes through these arteries. However, sometimes this pressure can be very high it causes a lot of strain on the vessels until they rupture and blood leaks. In the United States, at least 30% of people 20 years and above have hypertension.

Hypertension can also lead to aneurysms, wherein the walls of the arteries swell and become weak until they rupture, causing massive bleeding. The condition can also occur in the walls of the heart. Apart from high blood pressure, though, cerebral aneurysms can be congenital or caused by arteriosclerosis, the buildup of plaque deposits in the arterial walls due to high cholesterol levels.

Another possible reason is a head injury, especially a traumatic brain injury. The skull is a strong part of the head, but it doesn’t have the ability to absorb excessive impact. Depending on how strong the force applied to the head is, the skull can fracture, and the injury can reach the brain. It’s also possible that the skull remains intact, but the brain develops a subdural hematoma, or bruising and bleeding of some of the blood vessels in between the layers of the brain. Brain injury is especially risky for older people. A minor fall or hit on the head may already result in bleeding.

Rarely, affecting no more than 1% of the U.S. population, is arteriovenous malformation or (AVM). It is characterized by the tangling of the veins and arteries of the brain. While the arteries deliver the oxygen-rich blood to the brain, the veins carry the blood without oxygen to the heart and then to the lungs to release the carbon dioxide. Because of the tangle, their functions are hindered, and the blood vessels begin to swell until they rupture. AVM may be congenital or develop later in life.

Key Symptoms

  • Sudden painful headache
  • Muscle weakness or loss of muscle function
  • Inability to perform certain basic tasks like speaking correctly
  • Change of mood
  • Loss of memory
  • Sensitivity to light
  • Fainting spell
  • Paralysis or numbness
  • Loss of vision
  • Disorientation or confusion
  • Stiff neck
  • General feeling of being ill
  • Loss of consciousness
  • Seizure
  • Blurry vision
  • Vomiting

Contrary to popular belief, a brain hemorrhage doesn’t always result to a headache. In fact, the brain itself doesn’t cause headaches when bleeding since it cannot perceive any pain or disturbance. It occurs only when the bleeding is in the surrounding space such as the meninges.

Further, it’s possible that bleeding occurs even before the symptoms appear. This usually happens among hypertensive patients. For this reason, hypertension is often called the killer disease.

Who to See and Treatments Available

A brain specialist such as a neurologist can diagnose brain hemorrhage or bleeding. If it requires surgery, the doctor then works closely with a surgeon.

There are different ways to diagnose a brain hemorrhage, depending on the circumstances of the patient. For instance, if the patient starts to vomit, experience blurred vision, or lose consciousness after a fall or a vehicle accident, the emergency department would initially diagnose it as injury to the brain. If the patient slurs speech, lose strength on the arms, or becomes paralyzed, a brain hemorrhage due to stroke may be considered.

One of the best ways to conclude brain hemorrhage is through a CT scan, which creates an image of the various parts of the brain.

The treatment varies depending on the severity of the condition, the location of the bleeding, and the general condition of the patient, among others. Treating the bleeding as soon as possible—that is, within three hours from the onset of the symptoms—can lead to a better prognosis.

Usually, the first line of treatment is surgery to ease the pressure and avoid the further weakening of the arteries. The damaged blood vessels may also be operated on.

If the patient is not a good candidate for surgery, the next step is to delay the progression of the condition or relieve the symptoms such as headaches.

Prevention measures are also advocated especially to those who are at risk of hypertension and aneurysm. These include no smoking, eating a diet that is low in bad fat and cholesterol, exercising, and managing high blood pressure.

Resources:

  • American Stroke Association: "Let’s Talk About Hemorrhagic Strokes.
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