Cerebral hemorrhage

cerebral is a loss of blood inside the brain, with blood effusion in the tissues that compose it. It is caused by the rupture of a cerebral blood vessel, typically an "artery, following physical trauma or non-traumatic events. A" hemorrhage for example, it can be caused by severe head trauma (traffic accidents) or by conditions, such as emboli or congenital malformations, which undermine the resistance of the cerebral vessels facilitating their rupture. Treatment with anticoagulant drugs, as well as blood clotting disorders and hypertension, can also increase the risk of cerebral haemorrhage.

Symptoms depend on the location and extent of the bleeding. Severe headache, followed by vomiting, is one of the most common symptoms of cerebral haemorrhage. The condition is classified as intra-axial intracranial hemorrhage, that is, it occurs inside the brain tissue, rather than outside it. Blood can accumulate in brain tissues or in the space between the brain and the membranes that make it. they cover, causing swelling (cerebral edema) and hematoma. Cerebral edema and hematoma can cause a sudden increase in pressure inside the skull and cause irreversible damage to the involved brain tissues. Cerebral haemorrhage can be localized to only one hemisphere of the telencephalon (lobar intracerebral haemorrhage) or extend to other structures of the brain, including the thalamus, basal ganglia, cerebellum, brainstem or cortex (deep intracerebral hemorrhage). After a "careful evaluation, doctors can take emergency measures to reduce blood pressure and minimize effusion from the injured blood vessel. Prognosis can improve with intensive care, which aims to stop bleeding, remove the" hematoma and relieve pressure on brain tissues. The age and clinical condition of the patient are elements that contribute to defining the final prognosis.

(aneurysm or arteriovenous malformations);

High blood pressure: In the long term, high blood pressure can weaken the vessel walls. Chronic arterial hypertension is a leading cause of cerebral haemorrhage;

Hemorrhagic transformation of an ischemic stroke;

Deposition of amyloid substance in the blood vessels (amyloid angiopathy);

Traumatic brain injury: TBI is the most common cause of brain haemorrhage for people under the age of 50.

Other causes responsible for cerebral hemorrhage are:

• Hematological diseases and coagulation disorders:
• Platelet disorders (decreased levels of platelets);
• Disseminated intravascular coagulation;
• Haemophilia;
• Leukemia;
• Sickle cell anemia;
• Primary or metastatic brain tumors;
• Liver disease (associated with an increased risk of general bleeding);
• Therapy with anticoagulant drugs (example: warfarin, heparin, etc.).

In some cases, no cause can be found (spontaneous brain haemorrhage).

;

Decreased alertness, lethargy or confusion

Sudden weakness, tingling, or numbness of the face, arm, or leg, usually on one side

Loss of consciousness;

Temporary loss of vision;

Convulsions;

Difficulty speaking, reading, writing or understanding;

Difficulty swallowing and changes in the sense of taste;

Loss of fine motor skills (example: appearance of hand tremors);

Loss of coordination and balance.

It is important to consider that many of these symptoms are often caused by conditions other than a "brain haemorrhage."

due to the similarity of symptoms and clinical signs. Computed tomography (CT) and other diagnostic investigations allow you to determine the correct therapeutic approach:

• CT allows you to confirm the diagnosis and allows you to accurately assess the severity of neurological lesions.
• The magnetic resonance of the brain is necessary, however, to monitor the resorption of any hematoma and detect previous bleeding.
• Angiography allows the detection of cerebral aneurysms, arteriovenous malformations or brain tumors.
• A lumbar puncture (spinal tap) may be used occasionally to check for blood in the cerebrospinal fluid.

, the correction of any coagulopathy and the intervention on vascular lesions with a high risk of acute re-bleeding. Body temperature abnormalities (hyperpyrexia) are common and can be effectively treated. Respiratory irregularity, pulmonary edema, instability or increased blood pressure are compensatory reflex mechanisms determined by the Cushing effect and related to neurological injury. These cardiovascular and respiratory phenomena aggravate the prognosis, but can be predicted and managed. In general, patients with small blood effusions and minimal deficits are treated with medical therapy, while extensive hematomas, which compress brain tissues and can cause hydrocephalus (accumulation of fluid in the brain), are managed surgically. Surgery may be necessary. to relieve swelling and prevent further blood loss (re-bleeding).