What Is A Cerebral Hemorrhage And Why Can It Occur?

Cerebral hemorrhage is a serious condition that can be life-threatening. It consists of bleeding inside the brain that causes blood not to be distributed and not reach all parts of the organ properly.

It is the second leading cause of stroke or stroke. The problem is that mortality from cerebral hemorrhage, despite current treatments, is still very high. Furthermore, sequelae are frequent in people who manage to survive.

The incidence of this condition increases with age. However, this is not the only risk factor.

What is a brain hemorrhage?

A cerebral hemorrhage, as we pointed out in the introduction,  is bleeding that occurs inside the brain. It often causes sudden-onset neurological defects and even coma.

This is due to the lack of blood supply to other parts of the brain, as the blood does not continue its journey through the blood vessels. It is important to distinguish between cerebral hemorrhage and intracranial hemorrhage.

Intracranial hemorrhages include, in addition to cerebral hemorrhages, others that occur within the skull but not in the brain parenchyma. For example, intraventricular, subarachnoid, subdural and epidural hemorrhage.

Cerebral hemorrhage is one of the main causes of stroke. It is estimated that almost 15% of all strokes are caused by this origin. In addition, it has a very high mortality, especially in the first days.

Related symptoms

Cerebral hemorrhage, as just noted, is usually associated with a neurological defect that appears abruptly. Depending on the cause of the bleeding, it may progress very quickly (within 1 to 2 hours) or it may progress more slowly. Also, symptoms vary depending on the affected area.

In ischemic strokes, loss of strength in one half of the body is common. That is, if the bleeding occurred in the right part of the brain, the left leg and arm will be affected.

It is common for this same side to lose sensation or tingle. Speech and the ability to understand language may also be affected. Some people lose sight in one eye.

Headache, vomiting, loss of consciousness and even coma are common. Headache and vomiting are usually associated with increased intracranial pressure due to the cerebral hemorrhage itself.

Main causes of cerebral hemorrhage

Brain hemorrhage can occur for different reasons. It seems that age is one of the most relevant factors. The incidence increases with age and is higher in men than in women.

The main underlying cause is hypertension. This is because the cerebral arteries, which are small in size, are very sensitive to increased pressure.

Likewise, cerebral hemorrhage  can be triggered by trauma. It is one of the reasons why it is more frequent in the elderly, who tend to suffer falls.

Another source is amyloid angiopathy. It is a disease that consists of the accumulation of certain proteins in the walls of the arteries of the brain. It causes recurrent bleeding as the arteries become more fragile.

Blood disorders, especially coagulation disorders, promote the development of cerebral hemorrhages. However, in most cases, they are due to the use of certain medications, such as anticoagulants.

Brain hemorrhage can also occur in young people. The use of drugs such as cocaine or amphetamines increases the risk. Likewise, arteriovenous malformations are another relatively common cause.

How is a cerebral hemorrhage treated?

Brain hemorrhage is a medical emergency. Any symptoms or signs should be a reason to seek immediate medical attention.

The first thing to do is to stabilize the patient. As with any other bleeding, it is essential to prevent the person from going into shock .

In addition, intubation is often necessary to ensure the patient continues to breathe properly. Likewise,  platelet concentrates or fresh plasma can be given to stop bleeding.  It is recommended to do this if the person was already undergoing treatment with anticoagulants.

As the MSD Handbook explains, vitamin K also helps reduce bleeding in these people. In cases of severe arterial hypertension, hypotensives are indicated. However, this is very delicate, as if the voltage drops too low the damage is aggravated.

Surgery may be needed to treat cerebral hemorrhage. The intervention consists of extracting the accumulated blood and thus reducing intracranial hypertension. It is reserved for cases where bleeding has caused progressive neurological deterioration or affected the brainstem.

Possible complications and prognosis

A cerebral hemorrhage carries a very high risk of mortality. In fact, the death rate is estimated to be around 40%. Also, people who survive often have sequelae.

Most complications arise from the expansion of the hematoma or edema that forms around it. Also due to damage to the brain tissue itself due to lack of blood supply. There may be seizures, inability to communicate and vision problems.

Survivors often experience  severe headaches and loss of sensation and mobility. The prognosis is poor, although it varies depending on the severity of the bleeding.

However, most patients require additional treatments. Rehabilitation therapies can be aimed at improving speech, mobility, or restoring other functions.

Cerebral hemorrhage is severe

Anyone who survives a brain hemorrhage needs to consider a few things. From that moment on, it  is essential to keep strict control of blood pressure. It is important to adopt a healthy lifestyle to prevent a new episode.