Cerebral Hemorrhage

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Introduction

What is cerebral hemorrhage?

Cerebral hemorrhage is uncontrolled bleeding in the brain. It can occur from an injury or as a result of a leaky or burst blood vessel. This can happen when a blood vessel gets weakened enough that its wall can no longer withstand the pressure of the blood flowing through it.

High blood pressure, atherosclerosis (buildup of plaque in artery walls), and amyloid angiopathy (protein deposits in artery walls) can weaken blood vessel walls. Aneurysms, which are bulges in weakened areas, can form when blood vessels are damaged or they can be present at birth. Arteriovenous malformations, which are abnormal connections between arteries and veins that may be present at birth, are another vascular abnormality that can be a site of cerebral hemorrhage.

The brain has many blood vessels running through it and around it. If a blood vessel inside the brain bursts, blood can get into the brain tissue and cause inflammation and swelling. If one of the blood vessels on the surface of the brain breaks, blood can collect between the brain and the membranes that surround it (subarachnoid hematoma). This causes pressure on the brain. Both inflammation and pressure can damage the brain.

Symptoms of cerebral hemorrhage often come on suddenly. Cerebral hemorrhage is always an emergency and needs to be treated as soon as possible to save as much brain tissue as possible. While some people experience long-term complications of cerebral hemorrhage, others are able to recover completely.

Cerebral hemorrhage is always an emergency. Seek immediate medical care (call 911) for serious symptoms, such as severe headache, nausea, numbness or weakness, loss of the ability to see or speak, seizures, or change in level of consciousness or alertness, such as passing out or unresponsiveness.

Symptoms

What are the symptoms of cerebral hemorrhage?

Symptoms of cerebral hemorrhage are related to their location. Some can interfere with function of parts of the body, some can interfere with sensation, and some can interfere with thought processes.

Common symptoms of cerebral hemorrhage

Common symptoms of cerebral hemorrhage include:

  • Change in level of consciousness or alertness such as passing out or unresponsiveness

  • Difficulty swallowing

  • Difficulty with thinking, talking, comprehension, writing or reading

  • Loss of vision or changes in vision

  • Numbness or weakness

  • Paralysis

  • Seizures

  • Severe headache

Serious symptoms that might indicate a life-threatening condition

Cerebral hemorrhage is always an emergency and can be life threatening. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

Causes

What causes cerebral hemorrhage?

Cerebral hemorrhage can be due to head trauma or can occur as a result of weakened blood vessels, which can be present at birth or can occur due to processes that damage blood vessels.

What are the risk factors for cerebral hemorrhage?

A number of factors increase the risk of developing cerebral hemorrhage. Not all people with risk factors will get cerebral hemorrhage. Risk factors for cerebral hemorrhage include:

  • Amyloid angiopathy (deposits of protein in artery walls)

  • Arteriovenous malformations (abnormal connections between arteries and veins)

  • Atherosclerosis (buildup of plaque on the walls of the coronary arteries; atherosclerosis is a type of arteriosclerosis)

  • Cerebral aneurysms (life-threatening bulging and weakening of the wall of an artery that can burst and cause severe hemorrhage in the brain)

  • Head trauma

  • Hypertension (high blood pressure)

Reducing your risk of cerebral hemorrhage

You may be able to lower your risk of cerebral hemorrhage by:

  • Controlling your blood pressure

  • Eating a healthy diet

  • Exercising regularly

  • Quitting smoking

  • Taking precautions against falling

  • Using safety devices such as helmets and seatbelts when necessary

Treatments

How is cerebral hemorrhage treated?

In the event of a cerebral hemorrhage, treatment depends upon the cause of the hemorrhage, as well as its location and the amount of blood. Surgery may be needed, and medications may be given to control symptoms. After initial treatment, rehabilitation may be necessary to help recover functions that may have been lost.

Common initial treatments for cerebral hemorrhage

Common initial treatments for cerebral hemorrhage include:

  • Anticonvulsants to control seizures

  • Interventional radiology to treat abnormal blood vessels and to reduce blood flow to the bleeding area

  • Pain medications as needed to increase comfort

  • Surgery to drain blood clots or relieve pressure

Common therapies used in cerebral hemorrhage recovery

Once the bleeding in the brain has been stopped and initial treatments have been completed, the process of recovery begins. Therapies used during recovery may include:

  • Dietary counseling to help you maintain your strength and improve your diet, with the goal of controlling blood pressure and reducing the risk of atherosclerosis

  • Occupational and physical therapy to help with eating, swallowing or talking problems

  • Physical therapy to help strengthen the body, increase alertness, reduce fatigue, and improve functional ability

What are the potential complications of cerebral hemorrhage?

Complications of an untreated cerebral hemorrhage can be serious, even life threatening in some cases. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of cerebral hemorrhage include:

  • Difficulty swallowing

  • Difficulty with memory, thinking, talking, comprehension, writing or reading

  • Loss of vision or changes in vision

  • Paralysis or weakness

  • Permanent loss of sensation

  • Personality changes

  • Unconsciousness and coma
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 Jan 5
  1. NINDS traumatic brain injury information page. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/tbi/tbi.htm.
  2. Aneurysm in the brain. Medline Plus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/001414.htm.
  3. Balami JS, Buchan AM. Complications of intracerebral haemorrhage. Lancet Neurol 2012; 11:101.
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