Brain Hemorrhage - Easy to Prevent but Hard to Recover

What Is A Brain Hemorrhage?

A brain hemorrhage is the bursting of an artery in the brain. This discharge of blood can interrupt the normal circulation to the brain, leading to stroke, which occurs when part of the brain lacks oxygen. Strokes can cause permanent or temporary damage to the brain.

Bleeding within the brain can also raise the pressure inside the skull to dangerous levels. This high pressure can cause the hemorrhage to bleed quicker, leading to a vicious cycle of destruction within the brain. Brain hemorrhages can be deadly, and the damage that is caused by them is determined by the size of the hemorrhage, the amount of swelling in the skull, and how quickly the bleeding is controlled.

What Are The Types Of Brain Hemorrhage?

The types of brain hemorrhage are:

• Subarachnoid hemorrhage.

• Intraparenchymal hemorrhage.

• Epidural hemorrhage.

• Subdural hemorrhage.

What Are The Causes Of Brain Hemorrhage?

1. Subarachnoid Hemorrhage:

Subarachnoid hemorrhage usually occurs after trauma when the cortical surface vessels are injured and bleed into the subarachnoid space. Non-traumatic subarachnoid hemorrhage is commonly due to the rupturing of the cerebral aneurysm. During the rupture of an aneurysm, the blood can flow into the subarachnoid space. Other causes of subarachnoid hemorrhage include blood thinners, arteriovenous malformations (AVM), trauma, or idiopathic causes.

2. Intraparenchymal Hemorrhage:

Non-traumatic intraparenchymal hemorrhage usually occurs secondary to hypertensive damage to cerebral blood vessels, ultimately bursting and bleeding into the brain. Other causes may include rupture of an aneurysm, an arteriovenous malformation, arteriopathy, tumor, infection, or venous outflow obstruction. Intraparenchymal hemorrhage can also be caused by penetrating and non-penetrating trauma.

3. Epidural Hemorrhage:

Epidural hemorrhage can occur when the blood dissects into the latent space between the dura and inner table of the skull. Most commonly, this happens after a skull fracture in 85% to 95% of cases. In addition, to this there can be damage to the venous or an arterial vessel, allowing the blood to dissect into the potential epidural space resulting in the epidural hematoma. The most commonly damaged vessel is the middle meningeal artery below the skull's temporoparietal region.

4. Subdural Hemorrhage:

The multiple causes of subdural hemorrhage include head trauma, vascular abnormality rupture, coagulopathy, and spontaneous. Head trauma is the usual cause of the brain's motion relative to the skull, stretching and breaking the blood vessels crossing from the brain to the skull. If the blood vessels are damaged, they can bleed into the subdural space.

What Are The Symptoms Of Brain Hemorrhage?

There is no symptom in most patients, and the person comes to an emergency with a history of sudden unconsciousness. When blood pressure is checked and found to be elevated, and a CT scan shows a large amount of blood in the brain. So, a seemingly normal person dies due to a brain hemorrhage. It is a common presentation of patients with high blood pressure. Fortunately, some patients get:

• Sudden, severe headaches (thunderclap headaches).

• Dizziness.

• Slurred speech.

• Vision problems.

• Uncomfortable feelings.

• Vomiting.

• Seizures.

• Tingling or numbness in the arms or legs.

• Paralysis on one side of the body.

• Chest pain when their blood pressure rises.

Risk factors for brain hemorrhage:

• The common risk factor for brain hemorrhage is hypertension.

• Antiplatelet and anticoagulant medications can also increase the risk of a spontaneous brain hemorrhage.

• Cerebral amyloid angiopathy is linked to a build-up of amyloid proteins in the arterial walls, making them more prone to rupture.

• The rupture of an intracranial aneurysm (subarachnoid hemorrhage) may be spontaneous, precipitated by exertion, or from hypertension.

It is very distressing to see the patients dying with a brain hemorrhage. Medically, this is called intracranial bleeding or hemorrhage. A simple cycle leads to this fatal condition. High blood pressure leads to increased pressure inside the blood vessels, and brain vessels being delicate, ruptures leading to hemorrhage or blood flow into the brain. Most commonly, increased blood pressure is the culprit. Most of the time, patients do not recover and succumb to death.

Could we prevent this death? The answer is yes. The simple measure to prevent such death is to keep the blood pressure under control.

What Can We Do to Prevent Such Death?

As we discussed earlier, we need to control blood pressure. But, we can control it only if we know that we have high blood pressure. So, one has to be vigilant for the symptoms mentioned above. Also, every person in his or her 40s or 50s should get their blood pressure checked periodically. It is more important to be cautious if they have a family history of high blood pressure, obesity, diabetes, smoking, or other risk factors. If the patient is a known case, he should check blood pressure more frequently and with any new symptoms.

What Are The Measures to Reduce Blood Pressure?

Once detected, we should make changes in our lifestyle to control high blood pressure like a low salt diet, regular exercise, reducing weight, having green leafy vegetables, avoiding meat, smoking, and alcohol. Also, along with this, we should regularly take medicines prescribed by the doctor.

The common misconception is that many patients discontinue medicine once blood pressure is controlled because they think it is cured and do not need any medication. Patients with blood pressure need to be on medicine for life long with the change in dosage at regular intervals.

One should buy an electronic blood pressure apparatus for home BP measurements, as these are more reliable than a single reading taken in the hospital. One should make the chart of blood pressure and get it reviewed by the doctor. Some blood pressure medicines can cause side effects, but this should be discussed with the doctor and medicine, or the dose should be modified, but medicine should not be discontinued on its own.

I hope this helps you increase your knowledge regarding this condition, and your awareness can save some lives.