Cerebral haemorrhage

What is cerebral haemorrhage?

Cerebral haemorrhage is bleeding in or around the brain. This blood builds up in the brain tissue, ultimately damaging the brain tissue.

The brain is enclosed by three layers of meninges (membranes). The outermost layer is the dura mater followed by the arachnoid mater and the pia mater respectively. Cerebral haemorrhage can occur in the brain tissue itself, or between the meninges.

Difference between cerebral infarction and cerebral haemorrhage

Cerebral haemorrhage and cerebral infarction are two different things, although many think otherwise. Cerebral infarction is caused by a blocked blood vessel, whereas cerebral haemorrhage is caused by a torn blood vessel.

The collective name for both cerebral haemorrhage and cerebral infarction is a stroke, or cerebrovascular accident (CVA).

What causes a cerebral haemorrhage?

Bleeding occurs through a tear in a blood vessel. How this tear is caused depends on the type of cerebral haemorrhage.

Intracerebral haemorrhage

Intracerebral haemorrhage occurs in the brain tissue itself. In most cases, it is impossible to determine what caused the intracerebral haemorrhage. This type of cerebral haemorrhage often occurs in patients 65 years of age or older. Many of these patients have high blood pressure, diabetes, arteriosclerosis or a combination of the three. In most instances of intracerebral haemorrhage at a younger age, the cause can be identified as being abnormalities of the blood vessels, such as arteriovenous malformations (AVM), an abnormal jumble of arteries and veins.

Subarachnoid haemorrhage

A subarachnoid haemorrhage occurs between the pia mater and the arachnoid mater. It is often caused by an aneurysm, which is a bulge or ballooning in a blood vessel. In the case of a subarachnoid haemorrhage, the aneurysm involves one of the blood vessels located outside the brain. The aneurysm can rupture, causing blood to flow into the space between two meninges.

Subdural haemorrhage

A subdural haemorrhage is also caused by a trauma. This involves bleeding from the small blood vessels between the arachnoid mater and the dura mater.

Epidural haemorrhage

An epidural haemorrhage is when blood seeps in between the dura mater and the skull. An epidural haemorrhage usually results from trauma to the skull, often involving arterial bleeding.

Symptoms related to a cerebral haemorrhage

The symptoms related to a cerebral haemorrhage can vary and depend on the part of the brain where the cerebral haemorrhage occurs and the size of the affected area. The complaints arise abruptly and can include:

• Severe headaches
• Severe dizziness
• Double vision or blindness in one eye
• Unclear speech or inability to express oneself (fumbling for words)
• A crooked mouth
• Paralysis on one side of the body
• Spasms on one side of the body
• Loss of consciousness (coma)

When symptoms like paralysis occur on the right side of the body, bleeding occurs in the left hemisphere of the brain, and vice versa.

Depending on the severity of the cerebral haemorrhage, some of the above complaints may be permanent. New complaints may also arise. A stroke often has social and psychological repercussions in addition to physical consequences. Because they have difficulty communicating and their mobility is reduced, people who have had a cerebral haemorrhage can potentially end up on sickness benefit and their social contacts are likely to dwindle. In many instances, their family care for them, which can also be quite stressful, both physically and mentally. The consequences of a cerebral haemorrhage can therefore have a huge impact on the patient and their environment.