What Is A Brain Haemorrhage?

What is a brain haemorrhage? Well, a brain haemorrhage s a serious, potentially life-threatening, condition where blood leaks out of blood vessels over the surface of the brain. It is known as a subarachnoid haemorrhage because the bleeding occurs in the arteries that run underneath a membrane, or layer, in our brain called the arachnoid, which is just below the surface of the skull.

Is The Tendency To Have Brain Haemorrhages Inherited?

Rarely, brain haemorrhages can run in families. However, only events affecting first-degree relatives (mother, father, sibling, child) would normally be regarded as significant family history in this context. You need to discuss the significance of your family history with your own doctor.

Spontaneous brain haemorrhages (i.e. not caused by injury) are due to weakened or damaged blood vessels rupturing and bleeding within or around the brain. There is no room for bleeding within the confines of the skull, so any bleeding causes serious damage to brain tissue by increasing pressure within the skull and disrupting the normal blood supply to the brain.

When bleeding occurs deep within the brain (intracerebral haemorrhage), it causes sudden loss of neurological function in a part of the body (haemorrhagic stroke or 'cerebrovascular accident') and collapse.

Sometimes bleeding occurs on the surface of the brain (subarachnoid haemorrhage) and this causes a severe headache of dramatically sudden onset, associated with vomiting, sensitivity to bright light and, not infrequently, collapse and coma too. As with all things in medicine, the symptoms can vary, be mixed up, or may not always present with typical features.

Occasionally dilated blood vessels with weak walls (berry aneurysms) are in-born, but often the underlying problem is damage caused by smoking, high blood pressure and clogging of the arteries.

What Are The Symptoms For A Brain Haemorrhage?

There's often little or no warning that a subarachnoid haemorrhage is about to occur. Typically, the person collapses with a sudden headache unlike any they've experienced before. They may vomit, develop signs of meningitis, such as neck stiffness and dislike of light, and may rapidly become drowsy, confused and unconscious.

In milder cases, the illness may appear like migraine or meningitis due to an infection, but in severe cases it's quickly apparent that something is seriously wrong.

How's A Brain Haemorrhage Diagnosed?

Once a person reaches hospital, diagnosis is usually quickly confirmed with a CT scan of the brain.

What's The Treatment For A Brain Haemorrhage?

Those who survive the initial episode are at great risk of another bleed unless action is taken. The standard treatment used to be surgery, which involves opening the skull and clipping off the faulty blood vessel. This operation, known as clipping, is usually done within days, but in severe cases and the elderly it may be delayed for a few weeks. However, although the operation puts an end to the risk, it carries a risk of damage (although this risk is far less than that of a second bleed.)

In recent years, a new technique has been developed as an alternative to clipping. In this technique, known as endovascular detachable-coil treatment or coiling, a detachable plantinum coil device is inserted into the blood vessels via a small cut in the skin (usually in the groin) and passed up into the brain under x-ray guidance to block off the faulty vessel.

In 2005, a long-term follow-up study of patients treated with coiling showed that it's as effective as surgery, has a lower risk of complications and offers a greater chance of survival without disability. It's now the standard treatment for most aneurysms in most areas of the UK.

Recovery from any type of stroke tends to be slow. Intensive rehabilitation therapy, including physiotherapy, speech therapy and occupational therapy, are usually needed.

Depression is a common problem after stroke, and good psychological and drug treatments are essential to help recovery.

After decades of being viewed as a fairly hopeless condition where only a little positive treatment could be done, new approaches are at last starting to make some impact on recovery rates from strokes. For example, researchers have shown for the first time in humans that rehabilitation therapy may help a stroke survivor's brain rewire itself, leading to regained use of a previously unused limb.

Children can have a stroke, especially a subarachnoid haemorrhage. Hemi-kids is a special site for children with stroke, and includes some valuable inspiration for parents.