Health in Focus: How Bleeding in the Brain Affects the Body

Brain bleeds are a serious problem that can have a number of different causes.

For this week’s Health in Focus, Dr. Jay Jagannathan, with Jagannathan Neurosurgery, explains how it can occur and what treatment options are available.

Types of Brain Bleeds

• Hypertensive
• Aneurysmal
• Trauma-related (Subdural/Epidural Hematoma)
• Tumor
• Miscellaneous causes (Amyloid, Low Platelet count, etc)

Causes of Subdural & Epidural Hematomas

He says bleeding in the brain is a generic umbrella term, which is why it can have many different causes, because it’s not a specific disease.

“The most common we see is trauma,” he says. “And you see it a lot in older patients because a lot of the bridging veins in the brain can often times be weak and they rupture easily.”

Patients can get subdural hematomas, which are bleeds around the brains surface, and epidural hematomas, which are related more to fractures in the skull.

Older patients typically develop the subdural bleeds because their “bridging” tends to be weaker.

In younger patients, epidural hematomas are more common because of high-impact injuries and skull fractures.

Jagannathan says the symptoms of this kind of brain bleed tend to be a little more “insidious.”

“It is often times called a lucid interval where patients seem completely normal, then suddenly they deteriorate rapidly, so it is important that they get medical attention quickly and get a CT scan quickly.” He says.

But brain bleeds can have more causes than poor bridging and high-impact injuries. Strokes and aneurysms can also cause them.

“That sort of thing (is) sometimes seen as equally life threatening in those cases,” Jagannathan says.

Symptoms of Brain Bleeds

• Headaches
• Nausea/Vomiting
• Difficulty with walking/balance
• Arm/Leg weakness
• Personality Changes/Sleepiness

“Sometimes there are no symptoms at all,” Jagannathan says. “If the brain is compressed enough, and often times with active bleeds, you can end up with seizers and other types of overall dysfunction of the brain.”

Treatment

There are many types of treatments for a small bleed. In many cases it can be observed in the ICU.

“Intensive care setting is required because there is a risk of the bleed growing or a patient developing symptoms,” Jagannathan says.

But larger bleeds that start to put pressure on the brain might surgery.

Or if it has an underlying cause, doctors would treat that.

“A lot of times when there is underline cause, like an aneurysm or vascular malformation, it is important to treat the main cause because there is a risk of it re-bleeding, which a lot of time can be even more severe than the initial bleed,” Jagannathan says.