What is Brain Hemorrhage?
A brain hemorrhage is a type of stroke. It’s caused by an artery in the brain bursting and causing localized bleeding in the surrounding tissues. This bleeding kills brain cells.
Many people who experience a brain hemorrhage have symptoms as though they are having a stroke, and can develop weakness on one side of their body, difficulty speaking, or a sense of numbness. Difficulty performing usual activities, including problems with walking or even falling, are not uncommon symptoms. About 13% of all strokes are hemorrhagic strokes, or caused by bleeding into the brain.
Bleeding within the skull but outside of the brain tissue
The brain has three membranes layers (called meninges) that lay between the bony skull and the actual brain tissue. The purpose of the meninges is to cover and protect the brain. Bleeding can occur anywhere between these three membranes. The three membranes are called the dura mater, arachnoid, and pia mater.
Epidural bleed (hemorrhage): This bleed happens between the skull bone and the utermost membrane layer, the dura mater.
Subdural bleed (hemorrhage): This bleed happens between the dura mater and the arachnoid membrane.
Subarachnoid bleed (hemorrhage): This bleed happens between the arachnoid membrane and the pia mater.
Bleeding inside the brain tissue
Two types of brain bleeds can occur inside the brain tissue itself – intracerebral hemorrhage (also called cerebral hemorrhage and hemorrhagic stroke) and intraventicular hemorrhage.
- Intracerebral hemorrhage:This bleeding occurs in the lobes, pons and cerebellum of the brain (bleeding anywhere within the brain tissue itself including the brainstem).
- Intraventricular hemorrhage:This bleeding occurs in the brain’s ventricles, which are specific areas of the brain (cavities) where cerebrospinal fluid is produced.
Causes of Brain Hemorrhage
The most common cause of a brain hemorrhage is elevated blood pressure. Over time, high blood pressure can weaken arterial walls and lead to rupture. When this occurs, blood collects in the brain leading to symptoms of a stroke. Other causes of hemorrhage include aneurysm — a weak spot in the wall of an artery — which then balloons out and may break open. Arteriovenous malformations (AVM) are abnormal connections between arteries and veins and are usually present from birth and can cause brain hemorrhage later in life. In some cases, people with cancer who develop distant spread of their original cancer to their brain (metastatic disease) can develop brain hemorrhages in the areas of brain where the cancer has spread. In elderly individuals, amyloid protein deposits along the blood vessels can cause the vessel wall to weaken leading to a hemorrhagic stroke. Cocaine or drug abuse can weaken blood vessels and lead to bleeding in the brain. Some prescription drugs can also increase the risk of brain hemorrhage.
Symptoms of a brain hemorrhage depend on the area of the brain involved. In general, symptoms of brain bleeds can include:
- Sudden tingling, weakness, numbness, or paralysis of the face, arm, or leg, particularly on one side of the body
- Headache (Sudden, severe “thunderclap” headache occurs with subarachnoid hemorrhage)
- Nausea and vomiting
- Difficulty swallowing
- Loss of vision or difficulty seeing
- Loss of balance or coordination
- Stiff neck and sensitivity to light
- Abnormal or slurred speech
- Difficulty reading, writing, or understanding speech
- Change in level of consciousness or alertness, lack of energy, sleepiness, or coma
- Trouble breathing and abnormal heart rate (if bleed is located in brainstem)
Treatment for bleeding in the brain depends on the location, cause, and extent of the hemorrhage. Surgery may be needed to alleviate swelling and prevent bleeding. Certain medications may also be prescribed. These include painkillers, corticosteroids, or osmotics to reduce swelling, and anticonvulsants to control seizures.