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- What causes intracerebral hemorrhage (Brain bleeds)?
- What are the symptoms of intracerebral hemorrhage (Brain bleeds)?
- How is intracerebral hemorrhage (Brain bleeds) diagnosed?
- What is the treatment of intracerebral hemorrhage (Brain bleeds)?
- What is the rehabilitation goal after intracranial hemorrhage treatment?
Intracerebral Hemorrhage (Brain bleeds)
Intracerebral hemorrhage (ICH), or brain bleeds, occurs when blood vessels in the brain burst, with blood pressing on the brain tissues, causing decreased blood flow and lack of oxygen to the brain, resulting in the inability to perform its functions. Intracerebral hemorrhages are life-threatening conditions. Therefore, patients must get immediate medical attention as soon as possible.
What causes intracerebral hemorrhage (Brain bleeds)?
Many conditions can cause intracerebral hemorrhages or brain bleeds, including:
- Head trauma in a traffic accident, a sports accident, being hit with solid objects on the head, tripping, falling with the head hitting against objects causing brain damage.
- High blood pressure. Long-term hypertension can damage artery walls and cause brain bleeding.
- Atherosclerosis, also known as stiff arteries, is the buildup of fatty deposits in the wall of cerebral arteries.
- A blood clot in the brain can originate from within or without the brain. A blood clot in the brain clogs up an artery, causing the death of brain cells and subsequent bleeding.
- Cerebral aneurysms are due to localized weakening and ballooning of the walls of some blood vessels, which can rupture, resulting in blood pooling in the brain and brain swelling.
- Cerebral amyloid angiopathy. There is a buildup and precipitation of amyloid protein in the brain's artery walls, commonly found in the elderly and often associated with age-related degeneration of brain blood vessels and high blood pressure.
- Cerebral arteriovenous malformation (AVM) is a rare, complex malformation of abnormal blood vessels connecting arteries and veins in the brain. A tear in an AVM can cause brain bleeding.
- Bleeding disorders. Hemophilia, thrombocytopenia, or taking anticoagulant medications in heart disease patients are risk factors for bleeding.
- Brain tumor. A large tumor pressing on the brain's tissues can cause bleeding.
- Smoking, heavy alcohol consumption, and narcotics such as cocaine are all causes of cerebral aneurysms, which deteriorate and cause brain bleeding.
- Eclampsia and seizures occur in pregnant women and cause arterial spasms, unconsciousness, and bleeding in the brain.
- Neonatal intraventricular hemorrhage is common in premature babies weighing less than 1,500 grams. Neonatal intraventricular hemorrhage is bleeding into the ventricles that can cause disabilities and death.
- Abnormal collagen formation within the artery walls will gradually weaken the walls causing artery walls to tear and bleed.
What are the symptoms of intracerebral hemorrhage (Brain bleeds)?
The symptoms of a cerebral hemorrhage vary depending on the location and volume of the bleeding within the brain and skull. The signs and symptoms of a brain hemorrhage are as follows:
- Subarachnoid hemorrhage symptoms include thunderclaps, sudden severe headaches, dizziness, nausea, and vomiting.
- Tingling, weakness, or paralysis on one side of the face, arm, or leg
- Neck stiffness, dysphagia, and breathing difficulties
- Blurred vision, poor eyesight, sensitivity to light, and an unequal response of the pupils to light
- Loss of balance, central nervous system motor neuron dysfunction, poor coordination, or impaired judgment
- Aphasia. A verbal communication disorder, incomprehensible speech, slurred speech, inability to communicate for others to understand, inability to write or read
- Confusion, loss of alertness, lethargy, drowsiness, or unconsciousness
- An abnormal heart rate (in case of bleeding in the brainstem area)
- Seizures may occur.
How is intracerebral hemorrhage (Brain bleeds) diagnosed?
Intracerebral hemorrhage, or brain bleeds, is a medical emergency that requires immediate treatment and care. As soon as the patient arrives at the hospital, a medical doctor will take a history and perform a physical examination to diagnose hemorrhagic diseases, such as severe headache, sudden weakness, paralysis in any part of the body, seizures, syncope, etc. To make to diagnosis, the doctor will conduct a thorough evaluation as follow:
- Initial clinical assessment by a physician
- An X-ray CT scan is to identify the location of intracerebral hemorrhage or the area of brain damage. The scan enables the doctor to make differential diagnoses to determine the cause of the brain hemorrhage.
- An MRI scanor MRA examination by a magnetic resonance imaging machine detects abnormalities of the cerebral blood vessels. The test will identify the location, extent, and cause of brain hemorrhage.
- Electroencephalography (EEG).Assess the function of nerve cells in people experiencing thunderclaps, severe headaches, and dizziness but no known cause or epilepsy diagnosis.
- Complete blood count (CBC)
- Spinal tap test (CSF)to check for hydrocephalus and cerebrospinal fluid pressure and abnormalities.
- Aneurysm examinationand examination for arteriovenous malformation (AVM)
What is the treatment of intracerebral hemorrhage (Brain bleeds)?
Treatment for intracerebral hemorrhage, or brain bleeds, is determined by the amount and extent of the bleeding. Timely treatment can help reduce brain damage and speed recovery from intracerebral hemorrhage. The doctor will expedite treatments appropriate for each individual as follows:
- Surgical: A pooling of blood raises the pressure in the brain if the bleeding is extensive. To reduce brain swelling, a doctor may recommend one of the following procedures:
- Craniectomy to remove blood clots that cause brain swelling and help lower brain pressure.
- Burr hole surgery involves the insertion of a tube to drain the brain ventricles of excess blood and fluid.
- Aneurysm clipping surgery: The doctor may apply clips to the aneurysms that have not ruptured. The doctor may also consider angiography of the cerebral vessels for future reference.
- Arteriovenous malformation surgery involves removing the blood clot inside the AVM, using computer-guided radiation to seal the malformed blood vessel, and using special glue or clinical filler to help block the flow in small blood vessels that feed blood into the AVM.
- Medical treatment:If the bleeding area in the brain is small without any symptoms, the doctor may consider medications to control blood pressure to reduce cerebral edema and damage from intracranial hemorrhages, such as anti-anxiety medication, anti-epileptic medication, strong painkillers to relieve severe headaches, or stool softeners to prevent constipation and need to strain. The physician may perform a brain CT scan from time to time to assess the treatment results.
- Medication adjustments or new prescriptions: If a heart disease patient on anticoagulants develops a brain bleed, the doctor may consider adjusting or prescribing a new medication to prevent bleeding.
What is the rehabilitation goal after intracranial hemorrhage treatment?
The long-term goal of rehabilitation following intracranial hemorrhage treatment is to help the patient resume their regular daily activities as soon as possible and to prevent future intracranial hemorrhage. However, recovery time for each individual varies depending on the extent of the damage and symptoms. The rehabilitation treatment includes:
- Ongoing physical therapy tailored to the patient's specific needs.
- Speech therapy or communication therapy
- Physical and occupational therapy
- Lifestyle adjustment to reduce the risk of intracerebral hemorrhage.
How to prevent intracranial hemorrhage (brain bleeds)?
- Always wear a helmet and fasten your seat belt when driving or participating in contact sports where there is a risk of impact.
- Maintain normal blood pressure levels.
- Lower your cholesterol levels and lose excess weight to prevent high blood fats.
- Avoid drinking alcohol, smoking, and using narcotic drugs.
- Eat nutritious foods.
- Maintain a regular exercise routine.
- Maintain normal blood sugar levels to prevent diabetes.
- Anticoagulants should be used with caution to maintain clotting time within prescribed ranges. Inform the doctor about your medical history before taking any medication.
- An annual physical examination to detect abnormalities that could lead to intracerebral hemorrhage
