What Are the Chances of Surviving Bleeding in the Brain?

Brain bleeding or intracranial hemorrhage is bleeding between the brain tissue and the skull or within the brain tissue, which can be a serious and life-threatening condition.

The human brain has three membranes or layers called meninges between the bony skull and the brain tissue: dura mater, arachnoid, and pia mater. These meninges cover and protect the brain.

Brain hemorrhages are divided into two basic types:

• Bleeding within the skull but outside the brain tissue
  • Epidural hemorrhage: Bleeding that occurs between the skull bone and the outermost membrane layer, the dura mater
  • Subdural hemorrhage: Bleeding that occurs between the dura mater and the arachnoid membrane
  • Subarachnoid hemorrhage: Bleeding that occurs between the arachnoid and the pia mater
• Bleeding inside the brain tissue
  • Intracerebral hemorrhage or hemorrhagic stroke: Bleeding in the lobes, pons and cerebellum of the brain
  • Intraventricular hemorrhage: Bleeding in the ventricles, which are areas of the brain where the cerebrospinal fluid is produced

Brain hemorrhage predominantly results from the irritation of brain tissues, leading to swelling or cerebral palsy.

Swelling increases pressure on the arteries, causing them to burst and create hematomas. This blocks blood flow and deprives oxygen to the affected parts of the brain, eventually damaging and killing brain cells. Hematomas occur when blood collects and turns into a mass that can result in excess pressure and/or swelling in the brain.

The causes of brain hemorrhage may include but are not limited to:

• Long-term hypertension (high blood pressure)
• Trauma or injury (a blow to the head, a fall, or an accident)
• Atherosclerosis (hardening, thickening, and narrowing of the arteries due to accumulation of fatty deposits)
• Aneurysms (an abnormal bulge that weaken the walls of blood vessels)
• Blood clots
• Malformations in the brain arteries and blood vessels
• Amyloid angiopathy (deposition of amyloid on the walls of the arteries in the brain related to high blood pressure and aging)
• Bleeding disorders (sickle cell anemia and hemophilia)
• Brain tumors
• Liver diseases
• Smoking
• Heavy alcohol use
• Use of illegal drugs (cocaine)
• Conditions related to pregnancy or childbirth (eclampsia, postpartum vasculopathy, and neonatal intraventricular hemorrhage)

Signs and symptoms of brain bleeding may appear suddenly, develop gradually, or worsen with time.

Warning signs and symptoms may vary depending on the extent of the tissue affected and the nature and the location of bleeding. They may include:

• Lethargy
• Reduced alertness
• Abnormal taste sensation
• Numbness and/or weakness in the extremities (arms or legs)
• One-sided paralysis of the face or extremities
• Seizures that appear suddenly (without a previous history)
• Severe headache
• Difficulty swallowing, speaking and understanding spoken words
• Slurred speech
• Loss of motor skills
• Difficulty reading or writing (may be accompanied by tremors)
• Vision changes
• Dizziness
• Confusion
• Neck stiffness
• Nausea (could be accompanied by vomiting)
• Loss of consciousness, balance, and coordination

Apart from symptoms, a diagnosis of brain hemorrhage is based on:

• Physical examination (to evaluate physical symptoms)
• Neurological examination (to determine if there is any swelling in the optic nerves)
• CT scan, MRI, or magnetic resonance angiogram of the brain (to reveal the location and extent of the bleeding)
• Blood tests, electroencephalogram, urinalysis, and chest X-ray
• Spinal tap (to analyze the cerebrospinal fluid surrounding the brain)

Brain hemorrhages are treated by carefully analyzing the brain using various imaging tests to determine the location of internal bleeding. Prompt diagnosis and medical treatment help limit damage to the brain and improve the chances of recovery.

Treatment options include the following:

• Medications
  • Antianxiety drugs
  • Anticonvulsants
  • Antihypertensives
  • Painkillers
  • Corticosteroids
  • Diuretics
• Surgery
  • Surgery may be recommended to control bleeding and alleviate swelling
• Long-term rehabilitation
  • Physical therapy
  • Speech therapy
  • Occupational therapy
  • Changing lifestyle habits
• Preventive measures
  • Control blood pressure levels
  • Lower cholesterol levels
  • Lose excess weight
  • Limit alcohol
  • Quit smoking
  • Eat a healthy diet
  • Exercise regularly
  • Control blood sugar levels

Possible complications of bleeding in the brain include:

• Loss of brain function
• Stroke
• Seizures
• Physical or mental disability
• Adverse reactions to medications
• Death