How Cerebral Hemorrhages Occur
Cerebral hemorrhage is synonymous to hemorrhagic stroke. It is different from ischemic stroke, which is a condition wherein the blood flowing to the brain is disrupted. Hemorrhagic stroke happens when there is extensive bleeding in the brain tissues enough to kill other blood cells.
Cerebral hemorrhage comes in four forms –intracerebral hemorrhage, subarachnoid hemorrhage, subdural hemorrhage, and epidural hemorrhage. Intracerebral hemorrhage occurs when the bleeding happens inside the person’s brain. The symptoms and the prognosis of this disease vary greatly as to how big the bleed is and at what part of the brain it occurred.
In a subarachnoid hemorrhage, the bleeding takes place between the brain and the brain’s membranes. These membranes are physically wrapped around the brain. Subdural hemorrhage, on the other hand, means bleeding between the meninges. Meninges are the layers of covering that the brain naturally has. And lastly, epidural hemorrhage occurs when the bleeding is between the brain covering and the skull.
There are different causes as to why cerebral hemorrhage occurs. For on thing, it could be because of some injuries sustained by the brain. People below 50 years old who suffers from cerebral hemorrhage are very likely to have acquired it due to this cause. Older people are also prone to head injuries but they are also likely to develop hemorrhage the other way. But for them, minor head injuries are enough to cause it because their body is already frail and weak as they age.
Arteriovenous malformation is also one cause of cerebral hemorrhage. This condition may be congenital, meaning it is present since birth. Arteriovenous malformation is the term given to the anatomical abnormality of the veins and arteries of the brain. It has different symptoms and it won’t be detected unless they develop.
Aneurysm is another factor. Aneurysm is the weakening of the blood vessel walls due to swelling. And because it swells and thins, these vessels may eventually burst and bleed through the brain, causing the stroke.
People with hypertension or high blood pressure are also prone to cerebral hemorrhage. Because high blood pressure can also possibly weaken the walls of the blood vessels, the risks of bleeding, particularly the intracranial type is relatively high.
Another abnormality in the walls of the blood vessel that can cause cerebral hemorrhage is amyloid angiopathy. This condition may occur as one ages. Small-scale hemorrhages happening without any symptoms at all usually occur before the larger-scale hemorrhage having and showing different symptoms takes place.
The symptoms of cerebral hemorrhage may occur very suddenly and rapidly. And this is precisely why this condition is considered an emergency medical situation. Symptoms include sudden headaches, nausea, vomiting, seizure, and fainting. Neurological losses are also observed and these includes, but not limited to numbness, paralysis, loss of vision or speech, and confusion.
To diagnose cerebral hemorrhage, CT scans may be preformed on the brain. If and when this method cannot confirm the doctor’s diagnosis, a spinal tap is used. The spinal tap, also referred to as lumbar puncture, would rule out the possibility of other types of hemorrhage, therefore cerebral hemorrhage is established.
The treatment of this disease varies from its symptom and the main causes of the bleeding. The location of the brain where the bleeding took place is also of concern. But usually, radiology, both diagnostic and interventional, is used. Neurosurgery together with neuromedical management may also be performed on the more advanced cases.
Diagnostic surgery is used for pinpointing the hemorrhage’s location as well as identifying the nature of it. It is through interventional radiology that the treatment is carried out. It involves the use of a catheter either to close off or to widen the blood vessels leading to the brain. This is usually performed without any major surgery. Focused radiation may also used to correct erring blood vessels that cause the bleeding in the brain.
But if this non-invasive techniques fail, microsurgical or neurosurgical methods need to be carried out. This type of surgery aims to treat the leaky vessels, as well as the abnormal ones so that it won’t further cause any more bleeding.
