A brain bleed is the second most common cause ofstrokenext to blood vessel obstruction (cerebral ischemia).
Symptoms include head pain, vision changes, and weakness on one side of the body.
It is characterized by bleeding that causes the formation of a blood pocket (called ahematoma).
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The formation of a hematoma here places extreme external pressure on the brain.
Many of these symptoms are triggered by the swelling of the brain, known ascerebral edema.
Typically, the effects of a brain bleed are severe.
Are Brain Bleeds and Stroke the Same?
But not all brain bleeds cause stroke.
If it occurs, there is usually a precipitating factor.
Diagnosis
Imaging tests are the primary tools for the diagnosis of a brain bleed.
They can identify the location and size of a bleed as well asblood clotsand obstructions inside a blood vessel.
Brain bleeds are typically diagnosed with acomputed tomography (CT)scan.
A CT scan is a technology that composites multiple X-rays to create a three-dimensional image of the brain.
In emergency situations, CT scans are generally more sensitive to acute bleeds thanmagnetic resonance imaging (MRI).
These include:
Treatment
There are several treatment strategies for managing a brain bleed and preventing complications.
Emergency surgery may be needed.
Medical care may continue for weeks after treatment.
In some cases, no treatment may be needed if a bleed is small and non-progressive.
But close monitoring is necessary should the bleeding suddenly restart.
Often, rehabilitation is necessary after recovery from a brain bleed.
Surgery
Surgery is often needed for brain bleeds, particularly in emergency situations.
Prior to surgery, intravenous (IV) steroids may be used to reduce swelling in the brain.
You may need IV fluids to prevent worsening edema.
Intravenoussteroidsare often needed to reduce inflammation and edema.Anticonvulsant drugsmay also be necessary to control seizures.
Rehabilitation
After the immediate treatment of a brain bleed, you may needphysical therapyorspeech therapy.
Often, people recovering from a brain bleed need assistive care.
You may need to re-learn things such as how to eat, speak, or walk.
Rehabilitation following a brain bleed is similar to the process used for an ischemic stroke.
Summary
Bleeding in the brain is a serious medical emergency that can lead to disability or death.
If you suspect a brain bleed, call for emergency help.
Brain bleeding can be due to head trauma from a fall or accident.
Healthcare providers usually diagnose brain bleeding with imaging tests, including a CT scan or an MRI.
Treatment depends on the size and location of the brain bleed.
Rehabilitation may be needed to help you relearn how to do things like eat, walk, or talk.
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Saulle MR, Schambra HM.Recovery and rehabilitation after intracerebral hemorrhage.Semin Neurol.
2016 Jun;36(3):306-12. doi:10.1055/s-0036-1581995
