Intracranial hemorrhage is a type of stroke caused by bleeding in the brain. It may be a consequence of head injury or uncontrolled hypertension.

Your brain can’t store oxygen. It depends on blood vessels to deliver that with nutrients. So, when there is brain hemorrhage due to a leaking or a burst vessel, pressure builds up in your skull and brain, causing pressure against it. This creates difficulty for the oxygen and nutrients to reach your brain tissues and cells.

Brain bleeds are extremely common in accidents and traumatic injuries. People with neglected levels of high blood pressure are also likely to face this disorder. Brain bleed is a life-threatening medical emergency as it takes less than four minutes to kill your brain cells without sufficient oxygen. For the best outcome, immediate and expeditious treatment is extremely necessary.

The Types of Brain Bleeds: 

The term “brain bleed” is synonymous with intracranial hemorrhage in medical terms. Since it’s a broad term, healthcare providers usually try to ascertain the problem area by detecting the region of bleeding.

By this understanding, there are two main areas of bleeding:

  1. Outside your brain tissue, within the skull.
  2. Inside the brain tissue.

Let us delve deeper for a betterunderstanding of the condition. Your brain has three layers, almost like an onion. They are called membranes (meninges) found between the bony skull and brain tissue. The three membranes that cover and protect your brain are called the dura mater, arachnoid, and pia mater. Based on the region, there are few types of bleeding.

Extradural (outside the dura mater)
Subdural (between the dura mater and arachnoid)
Subarachnoid (between the arachnoid and pia mater)
Intracerebral/ Intraparenchymal (inside the brain tissue)
The bleeding can occur at any of these areas and it dictates the severity of the condition.

Are Hemorrhages Dangerous? 

The severity and consequence of brain bleed can depend on several factors:

  1. Cause of the bleed
  2. Area of the bleed
  3. Size of the bleed
  4. The time taken between the bleed and treatment

However, it can be life-threatening and may cause permanent brain damage because of the nature of brain cells which don’t recover once they die. Damage, therefore, can prove fatal and result in physical, mental, and task-based disability.

Symptoms of Brain Hemorrhage:

The first symptom that most people report experiencing in a brain bleed is a sudden painful headache. While this may be the first symptom, the others may vary:

  • Dizziness
  • Confusion
  • Nausea and vomiting
  • Slurred speech
  • Insomnia or excessive sleepiness
  • Sudden tingling, weakness, numbness, paralysis of the face, arm, or leg, especially on one side of the body

In addition to these symptoms, one may also experience: 

  • Difficulty swallowing
  • Vision loss
  • Stiff neck
  • Sensitivity to light
  • Loss of balance or coordination
  • Trouble breathing and abnormal heart rate
  • Seizures
  • Loss of consciousness and coma

Causes of Hemorrhage:

A brain bleed can occur after:

  • Head injury
  • High blood pressure
  • Aneurysm rupture
  • Tumors
  • Bleeding conditions or conditions that require blood thinners
  • Pregnancy and childbirth-related conditions
  • Conditions that affect blood vessel wall formation
  • Substance use disorder  
Diagnosis and Tests

A healthcare provider may diagnose a brain bleed after a physical examination, coupled with a neurological examination. After considering your medical history and symptoms, they may order scans for imaging of your brain(CT, MRI, or MRA) for further diagnosis. These tests help in understanding the location, extent, and cause of the brain bleeding.

Other tests may include:

  • Chest X-Ray
  • Urinalysis
  • Complete Blood Count
  • Lumbar puncture
  • Angiography (for aneurysm or arteriovenous malformation)
Treatment:

The healthcare provider may decide a treatment plan based on the severity and location of the bleed. The treatment may consist of surgery and/or medications. If severe, the possibility of supplemental oxygen with or without ventilator support, gastrostomy tube, and close monitoring in an intensive care unit may also be present.

Prevention: 

While you can’t prevent a brain bleed completely, you can take steps to reduce the probability. Some include:

  • Managing blood pressure
  • Maintaining healthy weight
  • Limiting alcohol consumption and quitting smoking
  • Eating healthy foods
  • Regular exercise

A brain bleed or Hemorrhage is a life-threatening situation that must be treated before it results in permanent damage or death. In case of any signs of hemorrhagic stroke, contact emergency services immediately.