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Cerebral Hemorrhage

Cerebral Hemorrhage

Intracerebral or cerebral hemorrhage is a type of intracranial hemorrhage (bleeding and accumulation of blood inside the cranium). Here is a brief overview of cerebral hemorrhage; its causes, symptoms, and treatment.
Abhay Burande
Last Updated: Mar 19, 2018
The term hemorrhage is defined as escape of blood from a ruptured vessel; it can be either external or internal. Brain hemorrhage refers to such bleeding that occurs in and around the brain, within the cranium. So brain hemorrhages are also called intracranial hemorrhages, which is classified into two types - intra-axial and extra-axial. While intra-axial hemorrhages occur within the brain tissues, extra-axial hemorrhage occurs within the cranium, but outside the brain tissues.
Intracranial hemorrhages are divided into four types - epidural, subdural, subarachnoid, and intracerebral hemorrhage. While the first three types comprise extra-axial hemorrhages; intracerebral or cerebral hemorrhage is an intra-axial hemorrhage that occurs within the brain tissues. In subdural hemorrhage, bleeding happens between the dura matter and the brain. Bleeding between the dura matter and the skull amounts to epidural hemorrhage; whereas bleeding that happens in the subarachnoid space (located between the arachnoid membrane and the pia mater surrounding the brain) is subarachnoid hemorrhage.
What is Cerebral Hemorrhage?

So, intra-axial hemorrhage happens within the brain tissues; and cerebral or intracerebral hemorrhage is an intra-axial hemorrhage. Cerebral hemorrhage can be of two types - intraparenchymal and intraventricular. As the names suggest, bleeding happens in the parenchyma, and the ventricular system respectively. While the brain parenchyma consists of neurons and glial cells, the ventricular system comprise interconnected cavities that are filled with cerebrospinal fluid. It is in these cavities that the fluid is produced.
Intraparenchymal hemorrhage is a serious medical condition that may lead to major disabilities, coma, and even death. Hypertension is the main cause for this condition. It can also be caused by physical trauma. Intraventricular hemorrhage is mainly caused by stroke or physical trauma. This type of cerebral hemorrhage is common in newborns, especially premature babies and those with a low birth weight. Mostly, such hemorrhage occurs within the first three days after birth.
  • Penetrating Head injury: This is the most common cause of cerebral hemorrhage in kids and adults below the age of 50.
  • Hypertension: If hypertension is not properly controlled for a long period of time, blood vessel walls may weaken and rupture, resulting in cerebral hemorrhage.
  • Aneurysm: This is a condition in which a blood vessel swells, as its wall weakens. The blood vessel may burst and cause bleeding in the brain.
  • Arteriovenous malformation: This is an abnormal congenital condition in which blood vessels are swollen and tangled, and the arteries flow into the veins. These malformations may bleed and compress brain tissues.
  • Cerebral amyloid angiopathy: The condition denotes angiopathy caused by amyloid (an insoluble fibrous protein) deposits on the walls of blood vessels in the central nervous system. This is mostly found in elderly people.
These are some of the most common causes for cerebral hemorrhage. Cerebral venous sinus thrombosis (blood clot in the dural venous sinuses) is an uncommon cause. Other reasons include primary or metastatic brain tumor, excessive anticoagulation, moyamoya disease, etc.
  • Loss of consciousness
  • Nausea and vomiting
  • Sudden headache
  • Delirium
  • Sudden and progressive neurologic losses like numbness, inability to move (paralysis), loss of speech or vision, confusion, etc.
  • Seizures (uncontrolled physical movements)
  • Noisy Breathing
  • Weakness in limbs
Computed tomography angiography (CTA) scan, angiogram, and magnetic resonance imaging (MRI) scan are the most common diagnostic tests that are used for determining the source, location, and severity of bleeding.

The abnormality that caused the bleeding, the location of the bleeding, and the size of the blood clot, are some of the factors that play a major role in deciding the course of treatment. Medications are used for lowering blood pressure, for arresting bleeding and clot formation, for reducing intracranial pressure, etc. Diagnostic radiology comprises different types of scans to detect the nature and location of the hemorrhage. Interventional radiology comprises minimally invasive, image-guided procedures that are often used for treating cerebral hemorrhage, without surgery. Some of these procedures involve use of focused radiation to amend irregular blood vessels that have been bleeding. Microsurgical techniques are employed to treat abnormal or leaky vessels.
In short, cerebral hemorrhage is a serious medical condition that has to be treated at the earliest, so as to avoid debilitating and life-threatening complications. As hypertension is considered as a major cause of such hemorrhage, the condition has to be controlled with proper diet, lifestyle, and medications. Avoid smoking and use of drugs like cocaine.
Disclaimer: This article is for informational purposes only, and should not be used as a replacement for expert medical advice. Visiting your physician is the safest way to diagnose and treat any health condition.