Brain Bleed (Intracranial Haemorrhage): Causes, Symptoms and Treatments

What Exactly is a Brain Bleeding?

An intracranial hemorrhage, also known as a brain bleed, is a form of stroke characterized by bleeding within the head.

The brain relies on a structure of blood vessels to provide it with the necessary oxygen and nutrients, as it is unable to store oxygen itself. When a brain bleed happens, blood vessels can release blood or burst. There is a buildup of blood within your skull and brain. As a result, there develops an accumulation of pressure on the brain, leading to a lack of nutrients and oxygen reaching the brain tissues along with cells.

Brain bleeds frequently occur following falls and traumatic injuries. They are frequently found in individuals who have uncontrolled high blood pressure.

A brain bleed is an extremely serious medical emergency. Your brain cells can die within just 3 - 4 minutes if they are deprived of oxygen. Prompt medical attention is crucial for optimizing the outcome of a brain bleed.

Causes of Brain Bleeding/Intracranial Haemorrhage

• High blood pressure: High blood pressure over time can lead to variations in the brain's arteries, increasing the risk of rupture.
• Age Group: It is more commonly observed in individuals over the age of 55, as there is a gradual accumulation of protein in the arterial walls known as amyloid angiopathy.
• Gender:  More prevalent among males.
• Race: Inequalities in the impact of this issue appear among different racial groups, with African Americans and Asians being more affected compared to whites. This discrepancy may be linked to the higher incidence of Hypertension within these racial communities.
• History of stroke: Significantly raises the risk by 23 times.
• Alcohol and illegal drug consumption: Using cocaine and amphetamines can significantly raise the risk.
• Concerning liver disease:  Raises the risk because of concerns related to blood clotting.
• Utilization of blood thinners.
• Major causes of the brain: Tumors, infection, vascular anomalies, and venous sinus thrombosis.

What are the Various Types of Brain Bleeding/Intracranial Haemorrhage?

• Epidural Haemorrhage: This hemorrhage takes place between the dura mater, which is the protective outer membrane surrounding the brain, and the skull.
• Subdural Haemorrhage: Bleeding occurs between the dura mater and the arachnoid membrane, two layers that cover the brain.
• Subarachnoid Haemorrhage: This kind of hemorrhage happens in the subarachnoid space, which refers to the space between the arachnoid membrane as well as the pia mater (the delicate innermost membrane covering the brain).
• Intracerebral Haemorrhage: Bleeding occurs directly within the brain tissue in the case of intracerebral hemorrhage.
• Traumatic Brain Injury (TBI): Different types of intracranial hemorrhage, such as epidural, subdural, and intracerebral hemorrhage, can occur as a result of traumatic brain injury, based on the type and intensity of the injury.

Seeking immediate medical advice from an experienced neurologist is crucial for addressing these kinds of intracranial hemorrhage. The necessary interventions, such as having surgery, medications, or supportive care, will be determined based on the level of severity and root cause of the bleeding.

Brain Bleeding Symptoms:

• Nausea and Vomiting
• Headache
• Altered Consciousness
• Changes in Vision
• Seizures
• Stiff Neck
• Personality or Behavioural Changes
• Dizziness or Loss of Balance
• Neurological Deficits

Brain Bleed Testing and Diagnosis:

A non-contrast computer tomography (CT) scan of the human brain is the preferred diagnostic study. It is suggested to undergo a CT or magnetic resonance (MR) angiogram after the patient's condition has stabilized.

Patients might suffer from delayed deterioration caused by re-bleeding, swells, hydrocephalus (fluid accumulation caused by the blood or brain swelling obstructing the body's drainage pathways), as well as seizures.

Brain Bleed Treatments:

• Monitoring and Observation: When dealing with small, solid bleeds, particularly if they show no symptoms, doctors may opt to closely monitor the condition. This involves conducting frequent neurological assessments and imaging studies, including CT scans or MRIs, to make sure that the bleeding is not worsening over time.
• Medication: The cause of the hemorrhage determines the best course of treatment, which may include medicine to alleviate symptoms, stop further bleeding, or treat comorbid diseases.
• Medication for Pain: If you're experiencing any headaches or other discomfort due to the bleeding, analgesics might be prescribed to you.
• If seizures do occur, a doctor may recommend anticonvulsant medicine to help control the condition.
• Effective Management of Blood Pressure: Medication to lower blood pressure may be recommended if it is determined that hypertension is a risk factor for future bleeding episodes.
• Coagulation Management: The management of blood clotting might involve the use of medicine in instances when bleeding is caused by a coagulation issue.

The following are examples of situations in which surgical intervention may be required:

• To alleviate pressure and prevent more harm, surgical evacuation may be necessary for large or growing hematomas that are putting a lot of pressure on the brain.
• To stop further bleeding after a subarachnoid hemorrhage from a burst brain aneurysm, surgeons may utilize techniques like endovascular coiling or cutting the aneurysm.
• Treatment for arteriovenous malformations (AVMs): These abnormalities can be addressed with surgical excision, embolization, or stereotactic radiosurgery to stop any further bleeding.
• Intracranial bleeding, especially that produced by AVMs or burst aneurysms, can be treated using minimally invasive endovascular techniques including coiling, stenting, or embolization.
• Physical therapy, occupational therapy, speech therapy, and cognitive rehabilitation are all examples of rehabilitation therapies that may be required to assist persons recover lost functions and enhance their quality of life after treatment.

An in-depth assessment of the patient's condition, imaging scans, and other diagnostic procedures will help a healthcare team decide on the best course of therapy. When it comes to cases of cerebral bleeding, the key to maximizing results is early intervention and effective care.