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NEUROLOGY SERVICES

Diagnosis & Treatment

Brain Hemorrhage

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How are Brain Hemorrhages Diagnosed?

Diagnosis

If a brain hemorrhage is suspected, your doctor will order diagnostic tests to determine if this is the case. An evaluation of your symptoms, along with the results of imaging tests, will be discussed and followed by recommendations on the best way to handle your brain hemorrhage.

  • Evaluation of your physical symptoms
  • CT scan (computed tomography), MRI (magnetic resonance imaging), and MRA (magnetic resonance angiography - These imaging tests are helpful when diagnosing a brain bleed, the location of the bleed, and the extent of damage to the brain
  • Electroencephalogram - Also called an EEG, an electroencephalogram measures brain activity. This test can help your doctor diagnose and monitor brain-related disorders like epilepsy. Your doctor may order this test if you exhibit signs of confusion or seizure.
  • Complete medical work-up - This will include a complete blood count (CBC), in addition to other blood tests. You may also undergo a chest X-ray, urinalysis, or other vascular testing.
  • Spinal tap - During this test, your doctor will extract the cerebrospinal fluid that surrounds the brain. This fluid is then analyzed for the presence of meningitis, leukemia, or other illnesses. Spinal taps are also used to administer spinal anesthesia (epidural) and medications. Some patients may experience a spinal headache after the procedure, but it is not common.
  • Angiography - This is an imaging test used to view the inside of blood vessels and organs, with specific attention being given to the arteries and veins of the brain. This test may be done to rule out an aneurysm or arteriovenous malformation.

How is a Brain Bleed Treated?

Treatments

Brain bleeds are considered medical emergencies. If you or someone you know received a blow to the head and is experiencing symptoms that could indicate a brain bleed, call 911. This is a serious condition and immediate medical attention is needed to reduce the complications that could arise from a brain bleed.

If physicians determine that a stroke has occurred, immediate action must be taken to stop the bleeding or eliminate the blood clot. Immediate medical attention can limit the damage caused to the brain, as well as increase your chances of recovery.

Brain bleed surgery

Certain conditions require surgery to correct a brain bleed:

  • Bleeding (hemorrhage) - Surgery may be required for immediate decompression of the brain to relieve pressure and eliminate blood that has pooled. Decompression is accomplished by drilling a hole in the skull and allowing blood to drain. Sometimes a craniectomy incision is needed (removing part of the skull to allow the brain swelling to expand) or a craniotomy (opening of the skull cavity).
  • Cerebral aneurysm - If the cerebral aneurysm has ruptured, doctors might be required to clip or embolize (seal off) the aneurysm by performing a craniotomy or an interventional/angiography-type procedure that prevents further rupture
  • Arteriovenous malformation (AVM) - In this case, surgery is performed using computer-guided navigation to remove the AVM. A special glue (filler) is used to block (embolize) the blood flow from smaller blood vessels into the AVM or block the blood vessels that supply the AVM, which can make surgery safer.
  • Nonsurgical treatment of hemorrhages - Depending on the size and location of the brain bleed, surgery is not always required; your doctor will discuss the options available

Nonsurgical treatments

When surgical options are not viable, other therapies could include:

  • Medication
    • Medication to control high blood pressure or anti-anxiety drugs
    • Anti-epileptic drugs may be prescribed to control seizures
    • Painkillers may be prescribed for severe headaches, and stool softeners may be given to reduce constipation and straining during bowel movements
    • Intravenous nutrients and fluids are administered intravenously (through a vein), or a feeding tube placed in the stomach (gastronomy tube) for patients who have trouble swallowing

Brain Bleed Recovery

Recovery

Long-term treatment and rehabilitation for brain hemorrhages aim to achieve the best possible outcome to return to daily living and a better quality of life. In addition, doctors look to avoid any future brain bleeds. Recovery and rehabilitation vary according to the severity of the brain hemorrhage.

Long-term treatments for rehabilitation after a brain bleed might include:

  • Physical therapy – Physical therapy can help patients regain motor skills that may have been affected by a brain bleed
  • Speech therapy - Depending on where the bleed is located on the brain, some patients may experience issues with speech
  • Occupational therapy - Assists patients in regaining mobility and helps them adapt to alternate care
  • Lifestyle changes
    • Quit smoking
    • Eat healthy, which includes lowering sugar and fat intake (to avoid diabetes and high cholesterol)
    • Maintain a healthy weight
    • Limit alcohol use
    • Keep blood pressure under control
    • Exercise regularly

FAQs

FAQs

Brain bleeds cause significant damage to the brain if not treated quickly. The lack of oxygen supplied to the brain prevents the nerves from sending signals to other body parts. Depending on the location of the brain bleed, this can result in memory loss, impaired speech, impaired movement, personality or emotional changes, headaches, seizures, and vision loss.

According to the Brain Aneurysm Foundation, a person’s survival rate for an aneurysm-related brain bleed is about 50%. Additionally, people who survive can experience additional neurological problems, such as speech or memory loss.

Yes. It is important to know the subtle signs and symptoms of a small or early brain hemorrhage. Time is your best chance to avoid further neurological damage to the brain. If you have experienced an injury involving your head, like a strike or extreme blow, call 911. Catching a brain bleed early and getting help can be the difference between life and death.

People experiencing a brain bleed may have muscle weakness or paralysis on one side of the body. They may exhibit signs of confusion or become unconscious. They may also show signs of speech difficulty, fainting, extreme headache, seizures, and light sensitivity.

Extremely serious. Act quickly if a brain bleed is suspected after a sudden onset headache or an extreme blow to the head to limit the brain damage.

Get Care

Trust NewYork-Presbyterian for Brain Bleed Treatment

NewYork-Presbyterian retains world-renowned neurologists and neurosurgeons who are prepared to address your neurological needs. Knowing the symptoms associated with a brain hemorrhage can make a difference in your quality of life. If a brain bleed is suspected, call 911. Do not wait. The experienced professionals at NewYork-Presbyterian are there to assist with rehabilitation for both the body and mind.