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Brain Hemorrhage

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Brain hemorrhage occurs when there is bleeding in and around the brain after a blood vessel rupture due to a stroke or traumatic brain injury.

What is Brain Hemorrhage?

Brain hemorrhage is also called as cerebral hemorrhage, intracranial hemorrhage, intracranial or cerebral hematoma. It occurs after a stroke or traumatic brain injury (TBI). The bleeding can occur:

  • Between the skull and the brain covering (intracranial hematoma)
  • Between the layers of the brain’s covering (subdural hematomas)
  • Between the membranes covering the brain and the brain (epidural hematomas)
  • Within the brain itself (cerebral hemorrhage)

Brain hemorrhage is a type of stroke that causes brain cell death due to the bleeding. 13% of the stroke cases involve brain hemorrhage.

The bleeding causes swelling of the brain tissues called as cerebral edema. The blood collects and is called as a hematoma. This increases pressure on the brain and reduces vital blood flow to the brain cells, killing them in the process.

Symptoms of Brain Hemorrhage

The symptoms of brain hemorrhage vary in individual patients. The symptoms depend on the location, severity of the bleeding as well as the amount of brain tissue involved. These symptoms develop over time in some individuals and in some they symptoms are acute. Some of the symptoms that indicate brain hemorrhage include:

  • Sudden, severe headache
  • Sudden seizures, with or without previous history of seizures
  • Weakness in the arms or legs
  • Headache followed by nausea and vomiting is the most common symptom of intracranial hemorrhage
  • Sudden loss of alertness
  • Vision changes
  • Tingling or numbness in the body
  • Loss of coordination and balance
  • Loss of consciousness
  • Problems reading, writing, speech
  • Difficulty understanding speech
  • Some may go into coma, before hemorrhage is detected

Causes and Risk Factors

Brain hemorrhage can occur due to the following causes and risk factors:

  • Traumatic head injury that causes bleeding inside the skull
  • Skull fractures
  • Brain aneurysm that causes weakening of blood vessels that causes it to swell. This blood vessel can burst and cause bleeding that leads to stroke
  • Arteriovenous malformation that may be congenital and lead to intracranial hemorrhage
  • High blood pressure can cause weakening of the arterial walls leading to stroke
  • Bacterial infection with Streptococcus mutans


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CT scans help in detecting intraparenchyma hemorrhage. Aspinal tap may also help in the diagnosis of subarachnoid hemorrhage. Contrast angiography as well as CT angiogram or MRI may also be needed to diagnose and decide the line of treatment.

Treatment and Management of Brain Hemorrhage

The management of brain hemorrhage depends on the type of hemorrhage. Treatment includes both medications as well as surgery. Medications like Factor Vlla, mannitol, acetaminophen, corticosteroids, etc.

Surgery is conducted in case of hematoma that is greater than 3 cm in size. Young patients that show structural vascular lesions or lobar hemorrhage are also considered for surgery.


Brain hemorrhage is often fatal, especially when the bleeding occurs in the brain stem. Mortality is about 34-50% by 30 days after the initial injury in case of spontaneous intracranial hemorrhage.

Brain hemorrhage is a serious condition that needs immediate medical attention. If you experience any of the above symptoms or some one around you exhibits such signs, call the emergency number immediately.

Written by: Saptakee sengupta
Date last updated: April 06, 2015

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