Brain Hemorrhage

A brain hemorrhage is a type of stroke. It occurs when bleeding into the brain kills brain cells.

It can occur as bleeding:

  • Inside the brain
  • Between the brain and the membranes that cover it
  • Between the layers of the brain's covering
  • Between the skull and the covering of the brain

Symptoms of a Brain Hemorrhage

Signs of bleeding inside the skull tend to come on rapidly and include:

  • A sudden headache
  • Steadily increasing neurologic losses such as weakness, inability to move, numbness, loss of speech or vision and confusion
  • Nausea and vomiting
  • Seizures
  • Loss of consciousness

Causes and Risk Factors for a Brain Hemorrhage

These include:

  • Head injuries. For people under the age of 50, this is the most common cause of bleeding inside the skull.
  • Abnormalities in blood vessels in and around the brain, such as an arteriovenous malformation.  These may be present from birth. They are only found if symptoms develop.
  • Aneurysm. This is a weakening in a blood vessel wall that swells. It can burst and bleed into the brain leading to a stroke.
  • High blood pressure. High blood pressure over a long time can weaken blood vessel walls.
  • Amyloid angiopathy: This is an abnormality in the blood vessel walls. It occurs more often as we age. It may cause many small, unnoticed bleeds before causing a large one.

Diagnosing a Brain Hemorrhage

Doctors hearing the symptoms a patient has may strongly suspect bleeding inside the skull.

This may be confirmed using a computed tomography (CT) scan of the brain. If not, a spinal tap can be used to confirm or rule out subarachnoid hemorrhage (bleeding between the layers of the covering of the brain). A spinal tap may also be needed if infection is suspected. Magnetic resonance imaging (MRI), CT angiogram and/or contrast angiography may be needed to complete the diagnosis and help doctors to decide on the proper treatment.

Treating a Brain Hemorrhage

Treatment for bleeding inside the skull varies, depending on what caused it, where it is and how large it is.

Treatment may include:

  • Diagnostic radiology
  • Interventional radiology
  • Microsurgical techniques can be used to treat abnormal or leaky vessels

Resources at Cedars-Sinai:

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