Bleeding can occur in the brain or around the brain:
- Bleeding occurs in the brain called intracerebral hemorrhage
- Bleeding between the brain and the subarachnoid cavity called a subarachnoid hemorrhage
- Bleeding between the layers of the lining of the brain (meninges) is called a subdural hemorrhage
- Bleeding between the skull and brain membrane called epidural hemorrhage.
Any bleeding will cause damage to brain cells.
The space inside the skull is very limited, so the bleeding will quickly lead to increased pressure and this is very dangerous.
Head injury is the most common cause of intracranial hemorrhage in patients under the age of 50 years.Other causes include arteriovenous malformations, the anatomical abnormalities in the arteries or veins in or around the brain.Arteriovenous malformation is a congenital abnormality, but only known to exist if it has caused symptoms.Bleeding from arteriovenous malformations can suddenly lead to fainting and death, and tends to strike adolescents and young adults.Sometimes the walls of the blood vessels become weak and prominent, called aneurysms.
The walls are thin aneurysms can rupture and cause bleeding.Aneurysms in the brain is the cause of intracranial hemorrhage, which can cause hemorrhagic stroke (stroke due to bleeding).
Intracerebral hemorrhage Intracerebral hemorrhage is a type of stroke caused by bleeding into the brain tissue.Intracerebral hemorrhage occurs suddenly, starting with a headache, followed by signs of neurological abnormalities (such as weakness, paralysis, numbness, speech impairment, visual impairment and confusion).It often happens nausea, vomiting, convulsions and loss of consciousness, which may occur within a few minutes.Usually done a CT scan and MRI to distinguish ischemic stroke with haemorrhagic stroke.The examination may also show the extent of damage to the brain and increased pressure in the brain.Lumbar puncture is usually not necessary, unless it is suspected meningitis or other infections.Surgery can prolong survival, although leaving heavy neurological disorder.The goal of surgery is to remove the blood that had accumulated in the brain and to relieve pressure inside the skull.Intracerebral hemorrhage is the most dangerous type of stroke. Stroke is usually widespread, especially in people with chronic high blood pressure. More than half pendeirta having extensive bleeding, dying within a few days.Patients who survive usually recover and partly conscious brain function returns, because the body will absorb the remaining blood.
Subarachnoid hemorrhage is sudden bleeding into the cavity between the brain and the lining of the brain (subarachnoid cavity).
The source of the hemorrhage is the rupture of a weakened blood vessel walls (whether an arteriovenous malformation or an aneurysm) suddenly.Sometimes atherosclerosis or infection causes damage to the blood vessels so that blood vessels burst.Rupture of blood vessels can occur at any age, but most commonly affects the age of 25-50 years.Subarachnoid Hemorrhage rarely occurs after a head injury.
Subarachnoid hemorrhage due to aneurysm usually causes no symptoms. Sometimes aneurysm pressing against a nerve or a small leak before rupture, causing early signs, such as headache, facial pain, double vision or other vision problems.Early signs may occur within a few minutes to a few weeks before aneurysm rupture. If there are symptoms should be immediately taken to the doctor in order to take action to prevent severe bleeding.
Aneurysm rupture usually causes sudden severe headache, which is often followed by a decrease in consciousness momentarily. Some patients in a coma, but most woke again, feeling confused and sleepy.
Blood and cerebrospinal fluid surrounding the brain will irritate the lining of the brain (meninges) and cause headaches, vomiting and dizziness.Heart rate and respiratory rate often fluctuates, sometimes accompanied by seizures.Within a few hours or even a few minutes, the patient re-drowsy and dazed.Approximately 25% of patients had a neurological disorder, which is usually in the form of paralysis on one side of the body.
Diagnosis is usually made based on the results of a CT scan, which can show the location of the bleeding.If necessary, a lumbar puncture may be done to see blood in the cerebrospinal fluid. Angiography performed to confirm the diagnosis and as a guide when it is done surgically.Approximately one third of patients die in the first episode because of the extent of brain damage.15% of patients die within a few weeks after the hemorrhage, respectively.Patients who did not undergo aneurysm surgery and survive, after 6 months of having as much as 5% risk of bleeding.Many sufferers of some or all mental and physical functions returned to normal, but neurologic abnormalities sometimes persist.Patients treated immediately and should not be strenuous.Pain medication given to treat severe headaches.Sometimes the drainage hose is installed in the brain to relieve pressure.Surgery to clog or strengthen a weak artery walls, can reduce the risk of fatal bleeding in the future.Surgery is difficult and very high death rate, especially in patients who are comatose or stuporous.Most surgeons advocate performing surgery within 3 days after the onset of symptoms. Delaying surgery until 10 days or so but it does reduce the risk of surgery increases the likelihood of rebleeding.