A brain hemorrhage is bleeding within the brain or brain cavity. The bleeding occurs when the relatively fragile blood vessels feeding the brain are damaged; they then leak blood, or hemorrhage, into the surrounding tissue and spaces. When the blood leaks directly into the brain, it is called an intracerebral (or cerebral) hemorrhage. When the blood leaks between the brain and skull, it is called a subarachnoid hemorrhage. A brain hemorrhage results in increased pressure within the brain cavity and potentially a loss of brain tissue due to the decreased blood flow and lack of oxygen (called an infarct, or stroke). Spontaneous hemorrhage occurs in approximately 40,000 people a year in the United States and accounts for 10-20 percent of all strokes (see Medscape).
Brain hemorrhages can be due to trauma or non-traumatic. A hit to the head such as that sustained from a car accident or fall can result in traumatic brain hemorrhage. The most common reason for non-traumatic bleeding within the brain is hypertension. An estimated 80% of intracerebral hemorrhage patients have a history of high blood pressure, and approximately 80% of subarachnoid hemorrhage patients have a ruptured aneurysm (which can be caused by hypertension). Other causes of non-traumatic brain hemorrhage include blood vessel damage and abnormalities, liver disease, bleeding disorders, and brain tumors.
The symptoms of a brain hemorrhage depend on the severity of the hemorrhage and its location, and sometimes symptoms will dissipate or suddenly worsen. The symptoms of a brain hemorrhage include seizures in the absence of a history of seizures; sudden severe headache; weakness, numbness, or tingling in the limbs; sudden nausea and vomiting; loss of motor skills and coordination; sudden vision changes; and loss of consciousness. All of the symptoms are caused by the effect of the blood loss and increased pressure on the brain tissue.
A suspected hemorrhage can be confirmed by magnetic resonance imaging (MRI) or computed tomography (CT) scans. These scans will also help medical personnel decide the course of treatment as the location and extent of brain injury and bleeding will determine what measures need to be taken. Treatment options may include corticosteroids to reduce swelling, diuretics to reduce edema (fluid accumulation), or even removal of part of the skull to allow the brain to swell with minimal damage depending on the specific circumstances.
Some patients fully recover from a brain hemorrhage, others suffer long-term complications, such as an additional stroke, medication side effects, and brain damage. To avoid a brain hemorrhage, doctors advise abstaining from smoking and drugs, to treat hypertension when diagnosed, avoid trauma by wearing safety helmets and belts, look into corrective surgery for known vessel abnormalities, and follow up with a doctor regularly if taking Coumadin, a medicine known to increase the bleeding risk.