They occur with blood leaks into the cerebral cortex or into the brain tissue. It can be in the form of heavy bleeding with a sudden rupture of the artery or a slow leaking form of venous bleeding that lasts for days. Thus, a different disease picture emerges according to the location of the bleeding (intra-brain-extra-cerebral), its source (arteries-veins), its duration (within minutes-days).
Cerebral Bleeding: Hypertensive Bleeding: It is the most common among brain hemorrhages and occurs more frequently in the elderly and generally in patients with blood pressure. As a result of bleeding due to arterial rupture into the brain tissue, a clot forms and puts pressure on the brain tissue. The disease has a sudden onset, develops within minutes and hours, and severe headache is usually accompanied by vomiting, confusion, paralysis of arms and legs. The clinical picture may rarely start with the epilepsy picture.
Treatment: If the bleeding is life-threatening and has caused serious compression in the brain tissue, the bleeding should be evacuated by surgical intervention. Otherwise, if it is small and not life-threatening, it can be expected to be cleared by the body. Medication is administered during this period.
Hemorrhages due to congenital vascular anomalies: These are mostly seen at young ages. It occurs with hemorrhages from a congenitally present abnormal vascular structure (Arteriovenous malformation=AVM, cavernoma). Again, sudden headache, vomiting, epilepsy, organ paralysis, coma can be seen. In treatment. The bleeding should be drained and the abnormal vascular structure causing bleeding should be removed.
ANEURYSM BLEEDINGS (Subarachnoid hemorrhages): It is usually seen in young and middle-aged people. It occurs when a bubble forms in a weak area in the congenital or acquired artery wall and then this weak vascular area is ruptured and blood is filled into the brain cavities. It is of sudden onset. The patient usually feels a severe neck pain after coughing, sneezing or straining or out of the blue. This is very different and severe than the headaches experienced up to that time. accompanied by vomiting and unconsciousness-fainting. The pain is especially in the nape of the neck, and the patient may think that his neck is involved in mild leaky bleeding. This may be a precursor to imminent heavy bleeding. In aneurysm bleeding, the aneurysm in the bleeding artery region of the patient is closed with both intravenous interventions and surgery, and the bleeding is eliminated. However, in order to perform these procedures, the patient should not be in a coma and should have a clinical condition suitable for surgery.
CHRONIC SUBDURAL BLEEDINGS: These are the bleedings in the form of slow leakage that occur with the rupture of the veins between the brain and the skull. The leak, which continues for days or even weeks, accumulates between the brain and the skull, creating increasing pressure. Headache, weakness in one side of the arm and leg, weakness, drowsiness, and coma occur in the later period, but these findings develop gradually over days. The disease is common in the elderly and alcoholics. Head trauma, which is usually not very severe, can cause this bleeding. It can be confused with dementia in the elderly. In the treatment, the blood collected outside the brain is surgically removed. As a result of the surgery, the patient regains his normal health.
