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Home :: Neurology Disorders

Cerebral Hemorrhage


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The average affected individuals range from middle aged to old. The onset is explosive with headache and vomiting. Loss of consciousness occurs and there is rapid deterioration. Hypertension is always present. Blood vessel rupture is present.

The area of the brain involved is more than the artery involved. One half of the brain may be shifted while convulsions are absent. Neck stiffness is present. Recovery is poor. Although they may appear for no obvious reason, prompt diagnosis is important. Some thunderclap headaches have serious underlying causes, such as bleeding in the brain. Intracerebral hemorrhage usually occurs in selected parts of the brain, including the basal ganglia, cerebellum, brainstem, or cortex.

Intracerebral hemorrhage occurs when a diseased blood vessel within the brain bursts, allowing blood to leak inside the brain. Hemorrhage within the meninges or the associated potential spaces, including epidural hematoma, subdural hematoma, and subarachnoid hemorrhage, is covered in detail in other articles. The pain of these sudden, severe headaches peaks within 60 seconds and usually fades over several hours. A less severe headache may linger for up to 10 days. When blood flow to the brain is impaired, oxygen and important nutrients cannot be delivered. There are many causes for a stroke, as shown in the table and discussed below. Bleeding into a cerebral hemisphere of the brain, including lobar, subcortical white matter, and basal ganglia hemorrhages. Blood flow to the brain can be disrupted by either a blockage or rupture of an artery to the brain. If the amount of blood increases rapidly, the sudden buildup in pressure can lead to unconsciousness or death. 

Causes of Cerebral Hemorrhage

The common Causes of Cerebral Hemorrhage :

  • A tear in the lining of an artery in the neck that supplies blood to the brain (carotid artery dissection).
  • This is a weakening in a blood vessel wall that swells. The thin walls of an aneurysm can burst and cause bleeding into the subarachnoid space and the brain, leading to hemorrhagic stroke.
  • A tear in the membrane that surrounds the brain and spinal cord, leading to a leak of spinal fluid
  • Poorly controlled hypertension over a long period of time can weaken blood vessel walls and increase the risk of intracranial bleeding.
  • For people under the age of 50, this is the most common cause of hemorrhage inside the skull. In the elderly, subdural hematoma after relatively minor head injury is not uncommon.
  • This is an abnormality in the blood vessel walls. It occurs with increasing frequency with aging. It may cause many small, asymptomatic hemorrhages prior to causing a large symptomatic one
  • Bleeding into the brain caused by the rupture of a blood vessel (intracerebral hemorrhage).
  • Death of tissue or bleeding in the pituitary gland (pituitary apoplexy).

Symptoms of Cerebral Hemorrhage

Some common Symptoms of Cerebral Hemorrhage :

  • Nausea and vomiting.
  • Brain symptoms.
  • Difficulty swallowing.
  • Seizures.
  • Loss of consciousness.
  • Difficulty speaking or understanding speech.
  • Weakness of any body part.
  • Loss of coordination.
  • Speech probles.
  • Vision symptoms.

Treatment of Cerebral Hemorrhage

Here is the list of the methods for treating Cerebral Hemorrhage :

  • The multidisciplinary team at the Stroke Program brings to the table the best of diagnostic radiology, interventional radiology, neurosurgery and neuromedical management.
  • Initiate fosphenytoin or other anticonvulsant definitely for seizure activity or lobar hemorrhage, and optionally in other patients.
  • Oral pain relievers don't work quickly enough to ease the sudden, intense pain.
  • Medicines used may include painkillers, corticosteroids or diuretics to reduce swelling, and anticonvulsants to control seizures.
  • Interventional radiology involves treatments that include passing a catheter to widen or to close off blood vessels in the brain without surgery.
  • Other treatments may be recommended, depending on the condition of the person and the symptoms that develop.
  • If bleeding in the brain is causing the headache, emergency surgical treatment may be needed.Intubate and hyperventilate if ICP is increased; initiate administration of mannitol for further control.
  • Maintain euvolemia, using normotonic rather than hypotonic fluids, to maintain brain perfusion without exacerbating brain edema.