Stroke Program - Cerebral Hemorrhage

While ischemic strokes happen when the blood flow to a part of the brain is interrupted, a hemorrhagic stroke is caused when there is bleeding into brain tissue that kills blood cells.

A cerebral hemorrhage can take several forms:

•    Intracerebral hemorrhages. This is bleeding inside the brain. The symptoms and prognosis of an intracerebral bleed vary depending on the size and location of the bleed.
•    Subarachnoid hemorrhages. This is bleeding between the brain and the membranes that cover the brain.
•    Subdural hemorrhages. This is bleeding between the layers of the brain's covering (the meninges).
•    Epidural hemorrhages. This is bleeding between the skull and the covering of the brain.

Causes

Intracerebral bleeds are the second most common cause of stroke, accounting for 30–60% of hospital admissions for stroke. High blood pressure raises the risk of spontaneous intracerebral hemorrhage by two to six times. More common in adults than in children, intraparenchymal bleeds due to trauma are usually due to penetrating head trauma, but can also be due to depressed skull fractures, acceleration-deceleration trauma, rupture of an aneurysm or arteriovenous malformation (AVM), and bleeding within a tumor. A very small proportion is due to cerebral venous sinus thrombosis.

Symptoms

Patients with intraparenchymal bleeds have symptoms that correspond to the functions controlled by the area of the brain that is damaged by the bleed. Other symptoms include those that indicate a rise in intracranial pressure due to a large mass putting pressure on the brain. Intracerebral hemorrhages are often misdiagnosed as Subarachnoid hemorrhages due to the similarity in symptoms and signs.

Treatment

Treatment for intracranial bleeding varies, depending on the underlying abnormality that caused the bleeding, the location of the bleeding and the size of the blood clot.

The multidisciplinary team at the Stroke Program brings to the table the best of diagnostic radiology, interventional radiology, neurosurgery and neuromedical management.

Diagnostic radiology involves the use of various types of scans to precisely identify the nature and location of the hemorrhage.
Interventional radiology involves treatments that include passing a catheter to widen or to close off blood vessels in the brain without surgery. Other types of interventional radiology involve using focused radiation to correct abnormal blood vessels that have bled into the brain.

Finally, microsurgical techniques can be used to treat abnormal or leaky vessels.

Article Tags: Stroke Program, Cerebral Hemorrhage, Bleeding Between

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