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How is a brain hemorrhage diagnosed?
If any kind of stroke is suspected, immediate evaluation is needed. Examination may reveal evidence of brain injury with weakness, slurred speech, and/or loss of sensations. Generally, a radiology examination is necessary, such as a computed tomography (CT) scan or magnetic resonance imaging (MRI) scan. The CT or MRI can highlight various features and location of brain bleeding. If bleeding inside of or around the brain is noted, further testing may be ordered to try to determine the cause of the bleeding. This additional testing can help to determine if abnormal blood vessels are present as well as the next step in either diagnosis or treatment. In certain situations, a spinal tap (lumbar puncture) may be required to confirm evidence of bleeding or rule out other brain problems.
What is the treatment for a brain hemorrhage?
Patients with bleeding inside of the brain must be monitored very closely. Early treatment includes stabilizing blood pressure and breathing. A breathing assist machine (ventilator) can be required to ensure that enough oxygen is supplied to the brain and other organs. Intravenous access is needed so that fluids and medications can be given to the patient, especially if the person is unconscious. Sometimes specialized monitoring of heart rhythms, blood oxygen levels, or pressure inside of the skull is needed.
After a person has been stabilized, then a determination of how to address the bleeding is made. This stabilization and decision-making process takes place very rapidly. The decision to perform surgery is based on the size and location of the hemorrhage. Not everyone with an intracranial hemorrhage needs to have surgery.
Various medications may be used to help decrease swelling around the area of the hemorrhage, to keep blood pressure at an optimal level, and to prevent seizure. If a patient is awake, pain medication may be needed.