Understanding INTRACRANIAL HEMORRHAGE

By avn
11:32 am Posted November 19, 2016
In Stroke

Intracranial hemorrhage refers to bleedings inside the skull. When bleeding occurs inside the brain or in the membranes surrounding the brain due to rupture of a blood vessel inside the brain, then it is called hemorrhagic stroke.

Hemorrhages inside the brain usually occur suddenly without any warning signs and tend to damage the strain cells very quickly. Hence, intracranial hemorrhages can be a life-threatening condition.

What happens during intracranial hemorrhage?

Blood and oxygen supply to the brain is required for the proper functioning of the brain. The blood vessels are responsible for carrying the essential nutrients to the brain. Any rupture or leak in any of the blood vessels that supply blood and oxygen to the brain will result in pooling of the blood near the leak or rupture thereby impairing the supply to other parts of the brain. The pooling of blood in the brain eventually increases the pressure in the brain, reducing oxygen supply, which results in the death of the brain cells.

Causes of intracranial hemorrhage:

  • Head injury due to a fall or accident.
  • Hypertension. This causes damage of the blood vessels leading to rupture or leak.
  • Aneurysm: A balloon-like bulge filled with blood in the wall of a blood vessel that bursts and bleeds in the brain.
  • Arteriovenous malformations (AVMs): Leaking of the blood vessels around the brain that are poorly formed.
  • Cerebral amyloid angiopathy: Accumulation of amyloid protein in the walls of the artery of the brain.
  • Treatment with blood thinners.
  • Brain tumor.
  • Smoking, excessive drinking, and illicit drug abuse.
  • Problems in pregnancy and childbirth such as preeclampsia.

Symptoms of intracranial hemorrhage:

  • Severe headache that develops suddenly.
  • Vision problems and dysphagia.
  • Loss of balance and coordination.
  • Speech difficulty, difficulty understanding, and confused state.
  • Change in the level of alertness.
  • Nausea or vomiting.
  • Tingling and numbness.
  • Loss of fine motor skills.
  • Seizure with no previous history of seizure.

Diagnosis of intracranial hemorrhage:

The doctor will evaluate the patient’s physical symptoms as well as read the medical history in detail. A brain CT scan may be required to check for internal bleeding. Also, the doctor might order an MRI to analyze the brain in detail to determine the cause of bleeding.

Immediate treatment of intracranial hemorrhage:

Bleeding inside the brain can be life threatening and needs to be treated immediately. Hence, the patient needs to be taken to the hospital immediately to determine the cause of bleeding, which will decide the treatment course.

Initially, medications will be prescribed to control the blood pressure and seizure. Pain medications are also prescribed if required to help the patient deal with the pain.

Surgery may be required to suppress the bleeding in case of a ruptured artery to decompress the brain. This will enable the release of pooled blood and also repair the damaged blood vessel. Decompression may be through a burr-hole procedure, craniotomy, etc. In case the bleeding is due to a ruptured aneurysm, then clipping of the aneurysm is done through craniotomy.

Long-term Treatment of intracranial hemorrhage:

Even if intracranial hemorrhage is treated immediately, there may be some neurological deficits experienced by the patients due to damage to the brain which would not be restored immediately. It may take a while before recovering completely. Recovery time varies according to each patient’s condition and the extent of damage to the brain. The patient may also require long-term rehabilitation treatments like physical therapy, speech therapy, occupational therapy, and also some lifestyle changes to reduce risk of another hemorrhage.

Prognosis:

A patient who is in coma or is severe paralyzed due to the intracranial hemorrhage may need nursing care for a long time. For those patients, who have come through the initial episode, would largely benefit with rehabilitation to speed up recovery.

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