Cerebral hemorrhage means bleeding into the brain due to rupture of one of the arteries in the brain. When bleeding occurs, the brain, which is inside the skull, which is an inflexible structure, remains under the pressure created by the fluid that fills it, is crushed, and various findings occur accordingly.
Types of brain hemorrhages
Epidural (between skull and dura, the outermost membrane of the brain)
Subdural (between dura and brain)
Subarachnoid (brain membranes) between )
Intracerebral (into the brain tissue)
EPIDURAL HEMATOMA: There is a membrane called DURAMATER on the brain. The vessels on this membrane may bleed due to the injury of the skull bones that are broken or cracked as a result of trauma. The resulting hemorrhage accumulates between the dura mater and the skull bones and causes compression of the brain. If the operation is not performed, brain death occurs and the patient dies.
SUBDURAL HEMATOMA: In severe traumas, the vessels on the brain can be damaged. The blood leaking from these vessels accumulates under the dura mater (brain membrane), causing compression of the brain again.
SUBARACHNOID (ANEVURYSM/BUBBLE) BLEEDING. There may also be bleeding under the arachnoid membrane, which is a very thin membrane that covers the brain. This type of bleeding is caused by bubbles called aneurysms in the veins.
INTRACEREBRAL HEMATOMA: Bleeding into the brain tissue. It usually develops in patients with hypertension or due to a sudden increase in blood pressure.
All these types of bleeding can develop in patients taking blood thinners (coraspin, plavix, kumadin).
TREATMENT
The aim of treatment is to save life, relieve symptoms, eliminate the cause of bleeding and prevent the development of undesirable conditions. Coma treatment can be summarized as placing a thin plastic tube in the fluid-filled areas in the head in order to lay the patient in a suitable position, keep the airway open, provide life support and reduce intracranial pressure.
Surgical treatment is usually needed. Through this craniotomy (OPEN), the skull is opened and the blood above or below the membrane or inside the brain is drained depending on the type of bleeding.
In bubble (aneurysm) bleeding, clips are placed on the aneurysm (open surgery) or through endovascular intervention by sending a coil (spring) into the brain using one of the inguinal arteries. The type of surgery will be determined after the angiography. Surgical intervention may also be required to remove large amounts of bleeding into the brain.
