Bleeding in the Brain. Causes? Symptoms? Treatment?

What is a Brain Haematoma?

Blood collecting outside a blood vessel is a haematoma and when this happens in the brain it can be called either subdural or epidural, depending on where it forms.

Subdural or Epirdural Haematoma?

Basically a subdural haematoma is bleeding between the brain cover and the brain itself, whilst an epidural haematoma is a bleed between the brain cover and the skull. The blood vessels running in the space between the brain and the skull can rupture and bleed during a traumatic brain injury, also known as tbi, when there is a blow to the head. Epidural haematomas bleed quickly and compress the brain rapidly, while subdural haematomas bleed much more slowly, but both types of bleeding can have devastating implications.

Brain Compression affects Breathing and Heart

As the brain is enclosed within the skull, when bleeding occurs there is nowhere for the blood to drain away. If blood builds up the brain gets compressed so much that oxygen-rich blood is prevented from flowing into brain tissue. This lack of oxygen causes additional brain swelling which, added to blood leaking from a torn vessel, forces the brain through a small hole at the base of the skull, called the foramen magnum. The section of brain directly contacting the bone around this hole becomes so compressed, that it stops working. This brain area controls breathing and heart rate, so the effects are critical and sometimes fatal.

How does Bleeding in the Brain occur?

Common risk factors and causes of bleeding on the brain include:
• Aneurysm.  Weakened blood vessel walls can bleed into the brain and cause strokes.
• Brain tumours.
• Head trauma.  Most common cause of brain bleeding for the under 50s.  This could be following a car accident, fall, or blow to the head in an assault.
• High blood pressure.  This chronic condition weakens blood vessel walls.  A major preventable cause of brain haemorrhages, it should be monitored by a doctor, with appropriate diet and lifestyle changes made to reduce the risk.
• Blood disorders.  Haemophilia and sickle cell anaemia can increase bleeding by decreasing levels of blood platelets.
• Liver disease.  This is associated with increased bleeding in general.W

What are the symptoms of bleeding on the brain?

The symptoms of brain haemorrhage vary, depending on the location of the bleed and its severity.  Symptoms may develop suddenly or over time.  They may progressively worsen or suddenly appear. As this is a life-threatening condition, seek immediate medical attention if you show any of the following symptoms:
• sudden severe headache
• seizures / fits
• weakness in an arm or leg
• nausea or vomiting
• decreased alertness, lethargy, confusion
• blurred or altered vision, or a sensation that the room is spinning or out of focus
• tingling, numbness or pins and needles particularly in the fingers or toes
• difficulty speaking
• loss of fine motor skills, such as hand tremors
• loss of balance or co-ordination sometimes affecting the ability to walk
• abnormal sense of taste
• loss of consciousness, in more severe cases

How is bleeding in the brain treated?

Immediate treatment from a doctor at hospital is very important.  The earlier bleeding to the brain is diagnosed and treated, the quicker pressure on the brain is relieved.  A doctor firstly needs to assess which part of the brain is bleeding and may run imaging tests, such as a CT or MRI scan, which can reveal internal bleeding or blood accumulation.  An eye examination looking for swelling of the optic nerve, blood tests and a lumbar puncture may also be needed.

Treatment for bleeding in the brain depends on its location, cause and extent.  A shunt may be inserted to drain the blood or neurosurgery may be needed to alleviate swelling and prevent bleeding.  Certain medications may also be prescribed including painkillers, corticosteroids or diuretics to reduce swelling, and anticonvulsants to control seizures.

Can people recover from bleeding in the brain?

How well a patient responds from a brain haemorrhage depends on the size of the haemorrhage and amount of swelling.  Some patients recover completely, however possible complications include stroke, loss of brain function, or side-effects from medications or treatments.  Death may still occur despite prompt medical treatment.

Medical negligence compensation and Bleeding in the Brain

If delay in medical treatment being provided was avoidable this may give rise to a claim for medical negligence compensation.  For example a GP who fails to recognise the symptoms, passing them off as migraine, may delay a brain haemorrhage diagnosis.  A delay of even a few hours is sometimes critical and the earlier the condition is treated, the more likely the patient is to recover fully.

Head Injury UK

If medical evidence indicates an earlier referral would have led to the patient having a better outcome, the patient may be entitled to compensation for injury.  Head Injury UK are specialist brain injury lawyers with many years experience in handling medical negligence claims involving brain injury, including haemorrhage and bleeding to the brain.  For free legal advice on whether you have grounds to claim compensation for medical negligence contact Clare Langford.



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