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A cerebral haemorrhage is bleeding from a ruptured blood vessel in the brain. Without prompt medical treatment, this can result in death. A person who survives may be left with permanent disabilities, depending on the location and severity of the brain damage. Cerebral haemorrhage is commonly referred to as a type of stroke.
Types of brain haemorrhage
The brain is wrapped in three membranes, each serving a different function. The innermost membrane contains the blood vessels. The brain is nourished and cushioned by cerebrospinal fluid, which is contained between this first membrane and the second membrane. The third and last membrane (dura) lines the inside of the skull and is comparatively thick and tough.
A intracerebral haemorrhage is any bleeding that occurs inside the brain tissue. Bleeding that occurs in the space between the first and second membranes around the brain is called a subarachnoid haemorrhage.
Symptoms
The symptoms of a cerebral haemorrhage vary according to the location and severity of the bleeding, but may include:
- Sudden onset of symptoms
- Weakness
- Clumsiness
- Numbness or pins and needles of the face, arm or leg – usually on one side of the body
- Paralysis on one side of the body
- Slurring speech or difficulty finding words
- Severe headache
- Nausea
- Vomiting
- Drowsiness
- Unconsciousness
- Dizziness
- Difficulty walking or loss of balance
- Confusion.
Strokes
‘Stroke’ or ‘brain attack’ are non-medical terms used to describe the disruption of blood flow to the brain. This may be caused by cerebral haemorrhage (haemorrhagic stroke) or by blockage of an artery (ischaemic stroke). Approximately one in 10 strokes is caused by cerebral haemorrhage. This type of stroke (haemorrhagic stroke) is usually much more severe than ischaemic stroke.
Cerebral haemorrhage results in a collection of blood, which clots. This puts pressure on nearby brain tissue and restricts the delivery of oxygen and nutrients. If not reversed with treatment, this can cause permanent brain damage. The major risk factor for haemorrhagic stroke is long-standing high blood pressure (hypertension) that weakens the walls of blood vessels, which then may split under the pressure.
Other risk factors for stroke (ischaemic or haemorrhagic) include:
- Cigarette smoking
- Uncontrolled diabetes
- Atherosclerosis
- Obesity
- A high fat, high cholesterol, high salt diet
- Family history
- Excessive alcohol consumption
- Advancing age
- Atrial fibrillation (irregular heartbeat).
Head trauma
Head injury may cause a subdural haematoma, which is sometimes included under the loose term of a stroke. This is a clot of blood that occurs under the dura (the outer membrane of the brain), which lines the skull bone. Concussion is a temporary bout of unconsciousness following a blow to the head. A severe blow to the head can break blood vessels and cause bleeding into the brain. Over time, repeated small haemorrhages can cause brain damage with similar symptoms to neurological disorders like Alzheimer’s disease and Parkinson’s disease.
Cerebral haemorrhage in children
Cerebral haemorrhage is relatively rare in children, with only 2.5 children out of 100,000 affected every year in Australia. Most cases occur in children under the age of two years. Sometimes, cerebral haemorrhages are caused by congenital (present at birth) weaknesses in the walls of the blood vessels. In approximately one-third of cases, the cause is unknown.
Diagnosis
Cerebral haemorrhage is diagnosed by different tests, including:
- Physical examination
- Computerised axial tomographic (CAT) scan
- Magnetic resonance imaging (MRI).
Treatment
Treatment depends on the location and severity of the haemorrhage, but may include:
- Admission to hospital
- Medications, including drugs administered intravenously (into the vein), often to lower blood pressure in the early phase after onset of haemorrhage
- Treatment for underlying causes, such as long-term use of antihypertensive medications
- Certain surgical procedures.
Any suspected signs and symptoms of cerebral haemorrhage require urgent medical attention. Dial triple zero (000) to call an ambulance to take the person to the nearest hospital emergency department.
Long-term outlook
A cerebral haemorrhage is a life-threatening emergency. Without prompt medical treatment, death may result. A person who survives may be left with permanent disabilities, since the brain tissue near to the ruptured vessel will be damaged or destroyed. The disabilities depend on the location and severity of the haemorrhage. Children seem to recover better than adults, probably because of the relative immaturity of their developing brains.
If you suspect a cerebral haemorrhage, seek urgent medical attention. The faster you can get treatment, the better the outlook for recovery. Some people make an excellent recovery following a haemorrhagic stroke.
Where to get help
- Your doctor
- Emergency department of your nearest hospital
- In an emergency call an ambulance, dial triple zero (000)
- National Stroke Foundation. Tel: (03) 9670 1000 or 1800 787 653
Things to remember
- A cerebral haemorrhage is bleeding from a ruptured blood vessel in the brain.
- Causes include high blood pressure, weakened blood vessel walls, head trauma or congenital conditions.
- A cerebral haemorrhage is a life-threatening emergency.
You might also be interested in:
Bleeding.
Blood pressure (high) - hypertension.
Stroke can occur in children.
Stroke is a brain attack.
Stroke prevention.
Stroke prevention for high risk groups.
Subarachnoid haemorrhage.
Subdural haematomas.
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