A brain hemorrhage is bleeding in or around the brain. There are a few types of brain hemorrhage: an intracranial hemorrhage is bleeding that occurs inside the skull; a cerebral hemorrhage, or intracerebral hemorrhage, is when there is bleeding around or within the brain itself, according to the Cleveland Clinic. Subarachnoid hemorrhaging refers to hemorrhages that occur in the tiny space between the brain and the thin tissue that covers the brain.
There are many causes of brain hemorrhaging. Some of them include a tangling of blood vessels, called an arteriovenous malformation (AVM); bleeding disorders; cerebral aneurysms; head injury; and the use of blood thinners. Drug use and smoking may also cause hemorrhages.
A subarachnoid hemorrhage is usually caused by a rupture of an abnormal bulge in a blood vessel in your brain, according to the Mayo Clinic. This bulge is called a brain aneurysm.
Brain hemorrhages can be deadly. Hemorrhaging occurs when an artery in the brain bursts. The damage a hemorrhage wreaks on the brain is determined by the size of the hemorrhage, the amount of swelling in the skull and how quickly the bleeding is controlled. Some people may be left with permanent brain damage while others recover completely.
This discharge of blood can disrupt the normal circulation to the brain, so it can lead to a stroke, which occurs when part of the brain is deprived of oxygen. Strokes can cause temporary or permanent brain damage. Hemorrhagic stroke accounts for about 13 percent of stroke cases, according to The American Stroke Association.
Bleeding within the brain can also raise the pressure inside the skull to dangerous levels. This high pressure can cause the hemorrhage to bleed faster, leading to a vicious cycle of damage within the brain.
Symptoms of a brain hemorrhage, often come suddenly. Some symptoms, according to the Cleveland Clinic, include:
- Sudden, severe headache
- Sudden numbness, tingling, weakness or paralysis of the face, arm or leg, particularly on one side of the body
- Difficulty with swallowing or vision
- Loss of balance or coordination
- Difficulty understanding, speaking (slurring nonsensical speech), reading or writing
- Change in level of consciousness or alertness, marked by lethargy, stupor, sleepiness or coma
Diagnosis & treatment
Many hemorrhages do not need treatment and go away on their own. If a patient is exhibiting symptoms or has just had a brain injury, a medical professional may order a computerized tomography (CT) scan or a magnetic resonance imaging (MRI) scan to check for brain hemorrhages.
Once a hemorrhage is diagnosed, the medical professional may monitor the bleeding by measuring intracranial pressure or by using repeated head CT scans. According to the U.S. National Library of Medicine, doctors may prescribe:
- nimodipine (branded as Nymalize) to prevent artery spasms
- medicines to control blood pressure
- phenytoin (Dilantin or Phenytek) or other medications to prevent or treat seizures
- painkillers and anti-anxiety medicines to relieve headache and reduce pressure in the skull
- stool softeners or laxatives to prevent straining during bowel movements
If there is a large amount of bleeding, surgery may be needed to drain the blood and repair damage, according to the Mayo Clinic. A doctor may also prescribe anticonvulsant drugs to control or prevent post-traumatic seizures after surgery.
Brain hemorrhages often occur as a result of head trauma. About 1.7 million cases of traumatic brain injury occur in the United States every year, according to the American Association of Neurological Surgeons, so it is important to protect the head. This is especially true for children and young adults. “It’s critical to protect children from head injuries because their brains are still developing and the tissue isn’t fully formed,” said Dr. Joseph Rempson, co-director of the Center for Concussion Care and Physical Rehabilitation at Overlook Medical Center's Neuroscience Institute in Summit, New Jersey. “According to research, the brain continues to evolve until an individual is 20-25 years old. If a child injures his/her brain they may not reach their full developmental potential from a memory or cognitive standpoint.”
These precautions can help prevent brain injury:
- Wear a seatbelt.
- Wear a helmet during sports and bike riding.
- Secure rugs to prevent falls.
- Avoid diving in water less than 12 feet deep.
There are other ways for a person to lower the chances of experiencing a brain hemorrhage in their lifetime. For example, avoid drug use. Cocaine use increases the risk of stroke among young adults, according to the University of Texas Southwestern Medical Center. Smoking cigarettes has also been linked to an increased risk of brain hemorrhages.