Intracranial hemorrhage

Description

An intracranial hemorrhage occurs when a vessel inside the brain or between the brain and the inside of the skull is damaged. The resulting buildup of blood (hematoma) squeezes the brain tissue. Intracranial hemorrhage can occur when the cushioning fluid surrounding the brain is unable to absorb a sudden shock. This causes damage to the brain, particularly its blood vessels, against the inside of the skull.

Head injuries, even those that cause only a brief loss of consciousness (concussions), may be minor, but the resulting intracranial hemorrhage is sometimes a life-threatening condition and often requires immediate medical attention.

In some cases of intracranial hemorrhage, surgery is necessary to remove the excess blood.

Symptoms

Signs of intracranial hemorrhage may appear immediately after a head injury, but in some cases, symptoms do not appear until several weeks later. The patient may feel fine after the head injury (the so-called light interval). However, over time, the pressure on the brain tissue from the accumulated blood increases, and the following symptoms develop:

• A worsening headache
• Vomiting
• Drowsiness
• Clouding of consciousness
• Different pupil sizes
• Slurred speech
• High blood pressure

The greater the volume of blood drained and the greater the pressure on brain tissue, the more severe the symptoms become:

• Lethargy
• Seizures
• Loss of consciousness

When to see a doctor?

Intracranial hemorrhage is a life-threatening condition, so you should seek medical attention immediately.

After a head injury, you should seek medical attention if:

• You were losing consciousness
• You have experienced the above symptoms of intracranial hemorrhage

Symptoms of intracranial bleeding may not appear immediately, so observe your physical, mental, and emotional state over time. For example, if someone is feeling well and talking without problems after a head injury but their consciousness becomes confused after a while, you should seek medical attention immediately.

Causes

The cause of intracranial hemorrhage is usually a head injury, which often occurs due to traffic incidents, falls, fights, and sports injuries. Minor head trauma can also cause intracranial hemorrhage, especially in the elderly and those taking anticoagulants and antiplatelet medications such as aspirin. Serious intracranial hemorrhage can occur even in the absence of wounds, bruising, or other signs of head injury.

Diagnosis

Diagnosis of intracranial hemorrhage is complicated by the fact that the patient feels well after the injury. It should be remembered that a frequent cause of deterioration of consciousness shortly after a head injury is hemorrhage inside the brain unless another condition is diagnosed. The following tests are performed to determine the size and localization of the hematoma formed:

• Computed tomography. This test uses a sophisticated X-ray machine linked to a computer to produce detailed brain images. During the study, the patient lies on a movable couch that moves inside a device that resembles a giant donut. Computed tomography is one of the most common methods for diagnosing intracranial hemorrhages.
• Magnetic resonance imaging (MRI) uses a huge magnet and radio waves to create a computerized image. When the test is performed, the patient also lies on a movable couch inside a tube or tunnel. MRI is used less frequently than CT scans to diagnose intracranial hemorrhages due to the length of time it takes to perform the study and its limited availability.

Treatment

In some cases of intracranial hemorrhage, no treatment is needed because the hematoma is small and does not cause symptoms. However, if not treated surgically, you must be monitored closely with repeated CT scans and intracranial pressure measurements because it will likely worsen in the days or weeks following the event.

If you are taking anticoagulant drugs such as warfarin, you may need therapy to reduce their effect and reduce the risk of rebleeding. Such therapy includes the administration of vitamin K preparations and fresh frozen plasma. Surgery is often required in the treatment of intracranial hematoma. The choice of surgical treatment depends on the characteristics of the hematoma. Types of surgery include:

• Drainage. If the blood pooling is clearly localized and does not contain a large number of clots, the surgeon may make a small hole in the skull and remove the accumulated fluid through it.
• Craniotomy. Large hematomas require a craniotomy, in which the surgeon makes large holes in the skull to remove the blood.

All these treatment options are available in more than 510 hospitals worldwide (https://doctor.global/results/diseases/intracranial-hemorrhage). For example, Intracranial hemorrhage treatment can be done in these countries for following approximate prices:

Turkey $7.1 K in 15 clinics

China $19.9 K in 5 clinics

Germany $21.7 K in 11 clinics

Israel $26.5 K in 6 clinics

United States $53.8 K in 5 clinics.

Rehabilitation

After surgical treatment, your doctor may prescribe medications from the anticonvulsant group for up to a year after the injury to control and prevent seizures. If seizures persist, more prolonged therapy may be possible.

Other conditions that may persist after surgery include:

• Amnesia
• Attention deficit disorder
• Anxiety
• Sleep problems
• Headache

The recovery period after an intracranial hemorrhage can be long, and full recovery is not possible in all cases. If you experience neurological problems after completing treatment, you will need to adjust your lifestyle, work activities, and physical activity under the supervision of your doctor according to your condition.

Lifestyle changes and home treatment

The most important thing in treating brain injuries is patience. Most adults recover in the first six months after the injury, and gradual improvement can occur up to two years after the incident.

Take the following steps to ensure smooth improvement:

• Get enough sleep and rest throughout the day when fatigue occurs
• Gradually return to your previous activities when your health normalizes
• Do not engage in contact or vigorous sports until authorized by your doctor.
• Consult your doctor before driving, bicycling, operating complex machinery, or playing active sports again. Slower reaction times may occur after an injury.
• Consult your doctor before starting various medications
• Refrain from drinking alcohol until you have fully recovered. Alcohol slows rehabilitation, and excessive alcohol consumption increases the risk of re-injury.
• Write down the things you can’t remember.
• Consult with family members or close friends before making important decisions.

Prevention

The following measures will help prevent or minimize head injuries

• Wearing a helmet (including children). Wearing a good quality, properly fitting helmet when playing contact sports, riding a bicycle, motorcycle, or skis, horseback riding, skating, snowboarding, and other injury-prone activities can help prevent brain damage.
• Seat belt. When riding in a car or on a motorcycle, buckle up and ensure your children do the same. This will prevent or minimize head injuries.
• Protect young children. Always use only a child-sized car seat, pad the corners and edges of tables with soft material, do not allow children to play near stairs, secure furniture and objects hanging on walls to prevent them from falling and do not allow children to climb on fragile and unstable objects.