What is cerebral hemorrhage, diagnosis and how to treat

Cerebral hemorrhage is a type of stroke, also called stroke, in which bleeding occurs around or inside the brain due to the rupture of a blood vessel, usually an artery in the brain. Learn more about hemorrhagic stroke.

It is a serious event, usually caused by a blow to the head, which can lead the person to a state of deep unconsciousness, in addition to feeling nausea, vomiting, decreased heart rate and loss of balance.

The diagnosis is made by imaging exams, such as computed tomography, magnetic resonance and angiography with or without contrast. In other cases, the doctor may also request lumbar puncture.

The treatment of cerebral hemorrhage is usually surgical, and aims to remove blood and clot to decrease the pressure within the brain caused by the bleeding.

Main symptoms

The symptoms of cerebral hemorrhage depend on the size of the bleeding and are usually:

Severe and sudden headache that can last for days; Numbness or tingling in any part of the body; Vomiting; Loss of balance; Tremor in the hands; Decreased heart rate; Generalized weakness; Swelling of part of the optic nerve, which can result in dark sight for a few seconds, decreased field of vision or blindness;

In more severe conditions there may also be sudden epileptic seizures or a profound and prolonged loss of consciousness in which the person is unable to respond to stimuli.

Does cerebral hemorrhage leave sequelae?

After hemorrhage, some people may have sequelae, such as difficulty speaking, swallowing, walking, performing daily activities or they may be paralyzed.

As soon as the first symptoms of cerebral hemorrhage appear, you should go to the doctor immediately so that treatment can be started, as the severity of the sequelae depends on the degree of bleeding.

The best way to avoid the occurrence of cerebral hemorrhage and, consequently, its sequelae, is to perform physical activities and have a healthy and balanced diet, low in fat and salt.

Causes of cerebral hemorrhage

The main cause of cerebral hemorrhage is head trauma, but there are still other conditions that can favor bleeding, such as:

High blood pressure; Genetic factors; Alcohol consumption; Use of drugs, such as cocaine and amphetamine; Amyloid angiopathy, which is the inflammation of small vessels in the brain; Blood diseases, such as thrombocythemia and hemophilia, which hinder the clotting process; Use of anticoagulants, as they hinder clotting, which can favor bleeding; brain tumors.

Another common cause of cerebral hemorrhage is an aneurysm, which is a dilation in a blood vessel. This dilation causes the walls of this vessel to become thin and fragile, and may break at any time, with bleeding.

The most common symptom of an aneurysm is headache. Some people report feeling hot, as if there is some type of leak. Learn more about the signs and treatment of cerebral aneurysm.

How the diagnosis is made

The diagnosis is made with imaging tests, such as magnetic resonance, computed tomography and angiography with or without contrast.

Magnetic resonance imaging allows visualizing the edema around the lesion and, thus, it is possible to know the degree of the lesion. Computed tomography, on the other hand, is important so that the doctor can check for hemorrhage and, thus, differentiate hemorrhagic stroke from ischemic stroke. See what causes stroke and how to avoid it.

Angiography is the diagnostic test that facilitates the visualization of the inside of blood vessels, and the shape, presence of malformations can be evaluated and also to diagnose the aneurysm, for example. Understand how it is done and what angiography is for.

Some people with cerebral hemorrhage, however, show normal results on MRI or computed tomography. Therefore, the doctor may request a lumbar puncture, which is the removal of cerebrospinal fluid from the hip bone, in order to be able to evaluate the CSF, since cerebral hemorrhage has blood in the CSF.

How to treat

Treatment for cerebral hemorrhage is usually done with surgery to remove the blood and clot and decrease the pressure within the brain caused by the bleeding.

In addition to surgery, treatment with medications to control blood pressure, seizures and possible infections may be indicated by the doctor. In more severe cases, blood transfusions may also be indicated.

To improve the quality of life after bleeding in the brain and avoid injury it is important to go to the physical therapist or occupational therapist. See what recovery after a stroke is like.

Main types of cerebral hemorrhage

Excess blood irritates brain tissue and leads to the formation of edema, which is the accumulation of fluids. Excess blood and fluids increase pressure on brain tissue, decrease blood circulation through the nervous system and cause brain cells to die. Cerebral hemorrhage can be classified according to the location that occurs in:

1. Intraparenchymal or intracerebral hemorrhage

This type of bleeding is most likely to happen in the elderly and that is when the bleeding is inside the brain. It is the most serious type, but also the most common in the population. It usually occurs due to tumors, coagulation disorders and malformed vessels.

2. Intraventricular hemorrhage

Intraventricular hemorrhage occurs in the cerebral ventricles, which are cavities in the brain in which the production of cerebrospinal fluid occurs. This type of hemorrhage usually occurs in premature newborns, in the first 48 hours after birth, and who had some complications at birth, such as respiratory distress syndrome, in which the baby is born with immature lungs, high blood pressure and pulmonary collapse, which is a respiratory complication in which there is not enough air passage. Learn more about lung collapse.

3. Subarachnoid hemorrhage

This bleeding usually happens due to the rupture of an aneurysm, but it can also be the result of a blow, and is characterized by bleeding in the space between two layers of the meninges, the arachnoid and the pia mater.

The dura mater, arachnoid and pia mater are the constituent layers of the meninges, which are membranes that line and protect the central nervous system. Subarachnoid hemorrhage usually occurs in people between 20 and 40 years old.