By Dr. Franz Browne

What is a Brain Hemorrhage?

A brain hemorrhage is bleeding from a ruptured blood vessel in the brain.

There are three types:

Intracerebral hemorrhage: Here the blood flows into the tissue of the brain itself.

Subarachnoid hemorrhage: This is when blood flows into the blood filled area between the inner two of the three membranes that surround the brain and spinal column.

Subdural hemorrhage: This is bleeding into the space just under the outer of these layers (dura mater).

A brain hemorrhage often causes a stroke. The severity depends on the site and the degree of bleeding. A stroke may also be caused by an embolism (blockage) or thrombosis (blood clot) which stops the blood flow to an area of the brain. The incidence of strokes is 2:1000 in the United Kingdom each year. A stroke is more common in people over 60 years of age and affects more men than women.

A brain hemorrhage causes damage in two ways. Firstly, there is a lack of oxygen and glucose to the brain cells due to the disrupted blood flow. In addition, bleeding produces clots (hematomas) that crowd and distort the surrounding delicate brain structures.

What causes a brain hemorrhage?

In an intracerebral hemorrhage, bleeding typically occurs from arteries that have been damaged by the buildup of fatty deposits (atherosclerotic plaques). Such plaques weaken the walls of the blood vessels.

Many patients who suffer a brain hemorrhage have a history of blood pressure which is a condition that adds to atherosclerotic damage.

The usual cause of a subarachnoid hemorrhage is the rupture of an arterial aneurysm, a weakened segment of artery that balloons out. Sometimes these dangerous distensions of the arteries are present from birth.

An individual may be born with a minor undetectable defect in one or more blood vessels in the brain. With time these minor defects stretch under the pressure of coursing through them. Eventually the aneurysm bursts, an event that can prove fatal within minutes.

A less common cause of subarachonoid hemorrhage is a cluster of abnormal blood vessels (angioma) inside the brain. Angiomas may eventually rupture.

The most common cause of subdural hemorrhage is a blow to the head (trauma). They occur most often among energetic young adults, and are usually caused by a fall, car crash, or sporting accident. Bleeding may occur some days after the original injury. The elderly are also at risk.

What are the symptoms of brain hemorrhage?

The symptoms are as follows:

Sudden, unusual, excruciating headache.

Stiff neck

Loss of speech and motor control in part of the body

Paralysis in one side of the body

Inability to focus the eyes, sudden crossing of the eyes, inability to move the eyes, and other visual disturbances.

Loss of consciousness or coma

Confusion

Laboured breathing

When should I see my doctor?

Any symptom of the brain hemorrhage is an indication to seek emergency care. A sever headache or any change in consciousness or mental function following a head injury requires prompt attention.

How is a brain hemorrhage diagnosed and treated?

The key feature is the immediate onset. Typicaly, the victim feels and acts normally one moment and then, within minutes, becomes gravely ill and may suddenly die.

A CT (Computed Tomography) scan will differentiate a brain hemorrhage from a cerebral embolism, and pinpoint the area of damage in the brain.

A needle may be inserted into the spinal column (lumbar puncture) to assess the spinal fluid.

In major intracerebral hemorrhage and in almost all subarrachnoid hemorrhage, the cerebro-spinal fluid is bloodstained.

The victim may need to be put on a life support system. Drugs may then be given to lower blood and intracerebral pressure.

In the case of a hemorrhage due to a head injury, emergency surgery may be performed. If the burst vessel is near the surface of the brain, surgery can be life-saving and will minimize brain damage. But if the ruptured vessel is deep inside the brain, surgery may save life, but at a probable cost of further damage to the brain.

Once the patient is stabilized, care involves stringent bed rest in the hope the blood in the brain will slowly dissipate and that much or most function will return to damaged areas.

At this critical stage, a rehabilitation specialist will liaise with the medical team.

Modern rehabilitation techniques have greatly improved the outlook for victims of certain types of brain hemorrhage.

However, recovery from a brain hemorrhage is often lengthy, requiring a great deal of care and much encouragement.

How can I avoid brain hemorrhage?

Have your blood pressure tested regularly, as you grow older. If you have blood pressure, follow your doctor’s advice to keep it under control.

Consume a prudent, low fat diet, especially if you have elevated blood cholesterol.

Do not smoke, also take no alcohol.

Wear a high quality safety helmet when you ride a bicycle or participate in hazardous sports.

For further information, treatment or training do not hesitate to contact the Nevis Holistic Massage Centre at Farms Estate. Phone: 469-5464.