Neurosurgery


Brain Hemorrhage

Brain hemorrhage is bleeding into the brain due to rupture of one of the arteries in the brain. When bleeding occurs, the brain inside the skull, which is an inflexible structure, is exposed to the pressure induced by the fluid filling it, crushed and accordingly, various symptoms appear.

There are two types of brain hemorrhage: bleeding into the brain (intracerebral), and into the bottom of the brain membranes (subarachnoid), i.e., bleeding into surroundings of the brain.

In the case of bleeding into the brain, one of the small arteries inside the brain is torn. In this case, pressure occurs on the brain tissue where bleeding occurs, and dysfunctions in the body region governed by that area of the brain emerge. The most common cause of bleeding into the brain is hypertension. Blood vessels become weak and prone to tearing as a result of the effect of high blood pressure on small veins that has lasted for years. The most effective way of protection against this type of brain hemorrhages is to keep blood pressure within normal limits.

In the case of bleeding under meninges, one of the major arteries in basis of the brain is torn. In this case, the flowing blood spreads into all surroundings of the brain and into the cerebrospinal fluid. Cause of most subarachnoid hemorrhages is rupture of an aneurysm existing in the brain. Approximately 5 to 10% of all strokes occur due to subarachnoid hemorrhage.

The most common signs of bleeding in the brain are as follows:

  • The most common symptom is headache of sudden onset. This headache is often called " the worst pain experience ever ". An explosion may have been felt in the head before the pain. The pain in the whole head is usually more severe in the back of the head.
  • Nausea and vomiting may accompany the headache.
  • Clouding of consciousness, decreased alertness and degrading consciousness that may gradually reach coma can be seen.
  • Vision disorders, double vision, blind spots in vision, or sudden loss of vision in one eye may also occur.
  • Neck is painful and stiff. Light can irritate the eyes. Neck and back pains can be experienced.
  • The person may suffer a seizure. It may not be possible to move a region of the body or sensation in that region can be lost.
  • Personality disorders , confusion , irritability may occur.

If the patient is in a comatose state, he should be put into proper lying position, his airway should be kept open, life support should be provided and simple surgical interventions should be performed in the fluid- filled areas of the head in order to reduce intracranial pressure.

If the person is conscious, strict bed rest is recommended. At this stage, any activity such as leaning that will increase intracranial pressure should be avoided. The physician can also use medication to prevent spasm of blood vessels. Surgical treatment is usually needed in the case of brain hemorrhage because bleeding into the brain has to be removed.

The most effective way to prevent brain hemorrhages is to take control of the blood pressure and keep it in normal limits. To do this, one should use prescription drugs properly, lose extra weights, if necessary, and exercise regularly.