How does brain haemorrhage occur

Cerebral hemorrhage

Doctors understand cerebral hemorrhage various bleeding of the human brain. So it's one Generic term. In the human medical literature, between intracranial Bleeding (cerebral haemorrhage inside the skull), intracerebral Bleeding (bleeding that occurs immediately around the brain) and extracerebral Bleeding (meningeal hemorrhages) differentiated.

Definition: what actually is a cerebral hemorrhage?

Medical professionals differentiate between three different cerebral hemorrhages:

From one intracerebral cerebral hemorrhage is talked about when the bleeding directly in the area of ​​the brain occurs. Typically, intracerebral bleeding is not caused by traumatic circumstances such as an accident, but occurs suddenly. The characteristic feature of this bleeding is its location in the brain tissue, the so-called parenchyma. A further classification is possible depending on the cause, intensity and location of the bleeding.

Contrasted with intracerebral bleeding intracranial bleeding inside the skull on. Here it can, for. B. after traumatic brain injuries, bleeding between the brain and cranial bones, one epidural hematoma come. Functional consequences arise from the space occupation and the pressure on different regions of the brain.

Extracerebral cerebral hemorrhage form the third type of bleeding. The literature divides this into two subgroups a. If the person concerned has a bruise below the meninges, a Subdural bleeding spoken, which is also known as a subdural hematoma. In contrast, the Subarachnoid hemorrhage below the arachnoid membrane outside the brain. With this bleeding, accumulated by vascular sacs (aneurysms) in the blood vessels of the brain, blood can be detected in the cerebrospinal fluid (liquor).

Difference between a cerebral haemorrhage and a stroke

Bleeding in the head are known as cerebral hemorrhages. In the event of a stroke, certain areas in the brain are not supplied with sufficient oxygen. In the event of a stroke, there is insufficient blood flow, but no blood escapes. Cerebral hemorrhage in one area of ​​the brain (e.g. through an aneurysm) can be the cause of an insufficient supply of blood or oxygen to another area in the brain and thus trigger a stroke. In particular, however, a cerebral hemorrhage leads to functional disorders due to the local damage to brain tissue and, secondarily, due to its space-occupying effect and displacement of healthy brain tissue. Here the brain tissue can only escape to a limited extent, as it is limited by the rigid skull bone.

Symptoms: How to recognize a cerebral haemorrhage

Cerebral haemorrhages lead to a massive impairment of physical integrity. The majority of those affected complain about Nausea, vomiting and headache.

Cerebral haemorrhage can be associated with a stroke, which is why the typical symptoms a stroke can also indicate a cerebral haemorrhage. These are:

  • acute paralysis
  • sudden, severe general malaise and weakness
  • sudden dizziness and incoordination
  • sudden changes in speech and sensation
  • sudden changes in vision and breathing problems
  • acute loss of consciousness and disorders of consciousness

Diagnosis of a cerebral hemorrhage

Cerebral haemorrhage cannot be diagnosed solely by assigning objective symptoms, since it is not externally visible. A reliable diagnosis therefore always requires implementation imaging procedures such as computed tomography (CT), magnetic resonance imaging (MRT) or, less often, a vascular imaging (angiography).

The standardized first aid usually uses one CT scan back as the procedure Results faster than an MRI supplies. Both CT and MRI enable the treating physicians to determine the position and size of the cerebral haemorrhage. Changes in size can be detected by repeating the imaging procedure at a later point in time.

According to the current state of medicine are MRI exams Especially indicated when the patient has been stabilized, because in contrast to a CT, an MRI can also show older bleeding as well as aneurysms or similar malformations.

Course of the disease and prognosis

The course of a cerebral hemorrhage is strongly dependent on individual cases. Essential Factorsthat have a massive influence on the course of the disease

  • age,
  • the general condition,
  • possibly existing underlying diseases as well as especially
  • the location and type of cerebral haemorrhage.

Medical studies have shown that the Mortality rate with minor cerebral hemorrhages between 30 percent and 50 percent (mortality rate) lies. Extensive cerebral hemorrhage is even more common in death. It occurs in a large number of patients who survive a cerebral haemorrhage long-term to permanent consequential damage how

  • Paralysis of the arm and leg,
  • Speech disorders (speaking and understanding),
  • Disturbances of attention, memory and planning ability (so-called neuropsychological disorders) and
  • other mental or physical impairments.

Treatment of a cerebral haemorrhage

Cerebral hemorrhages are medical emergencies. As a result, the time factor plays an important role in treatment. The longer it takes to initiate adequate treatment, the higher the likelihood of death or consequential damage remaining. If there is a specific suspicion of a cerebral haemorrhage, the nearest hospital should be visited immediately or the emergency doctor should be called. The clinic should have medical equipment (stroke unit) that enables appropriate diagnosis and treatment.

At the beginning of the acute treatment, doctors first try the Stabilize patient. Since the brain functions of those affected are impaired, including the respiratory center, they often have to be artificially ventilated. If there is a cerebral hemorrhage Increase in internal pressure in the skull, an operation must be initiated. During this operation, the neurosurgeons open part of the skull bone to stop the bleeding and remove any bruises. Preserving blood may be necessary to compensate for massive blood loss.

Rehabilitation after acute treatment

When the patient has survived the critical phase, the rehabilitative begins Long term treatment. Various measures are taken here to limit the extent of the consequential damage and to prevent further bleeding. With extensive rehabilitation measures, the therapists, nursing staff (therapeutic-activating care) and doctors try to eliminate mental and physical dysfunctions or to limit their effects on quality of life. The sooner the rehabilitation measure begins in a neurological specialist clinic, the greater the chance of avoiding or reducing the consequential damage caused by a cerebral haemorrhage.

During the rehabilitation, those affected will of course receive medical care. In addition to the medical consultation and advice, the adapted medication to.

Our brain controls and monitors physical and spiritual Functions. Therefore paralysis, sensory disorders, but also speech and memory disorders are possible as a result. In the rehabilitation these are examined and treated intensively. The brain remains capable of learning into old age. It is scientifically assumed that areas of the brain that have been spared take on tasks and that slightly damaged regions can even partially recover.

Cerebral haemorrhage can affect people of any age.

Children and adolescents usually require special neuropediatric rehabilitation. The still developing body and mind need therapies suitable for children. The caregiver and parents often also need long-term support in coping with the illness. In a neuropediatric rehabilitation clinic or other facility, they are included in the therapy concept for their children. Sometimes a change of school is necessary if the course is severe. As part of the rehabilitation, the children and young people are also often taught in a "clinic school".

Achievement of rehab goals

The prerequisite for achieving the rehab goals is targeted To practice with therapeutic help and developing a good one Self-assessment of the person concerned. Since our brain also determines our personality and thus our ability to assess ourselves, a cerebral haemorrhage can also lead to an incorrect assessment of our own abilities. Therapists, specialized nursing staff and doctors help those affected and their relatives to do the right exercises and to develop an appropriate awareness of their own strengths and weaknesses.

Modern therapy is carried out by many highly specialized therapists who coordinate intensively and regularly. Occupational therapy, physiotherapy, sports therapy, art and music therapy, speech therapy, balneophysical therapy, neuropsychology and clinical psychology, garden therapy and curative education / pedagogy are available to those affected.

Therapy today uses modern ones if necessary Roboticsequipmentto improve walking or arm functions (grasping, etc.), for example. Regular repetition helps the brain relearn lost skills. Scientifically tested methods, for example in neuropsychology, are also used to improve mental functions (attention, memory, planning skills, problem solving and language). Modern computer programs are often used for this.

They are also very significant Self-exercises of those affected. Therapists provide specific guidance on this - also for self-training after the stay in the clinic.

perspective

Heavy cerebral hemorrhage changes this Perspective on life and planning. Psychologists, social workers and doctors support those affected and their families in developing new perspectives. The primary goal is to return to the family environment, to the workplace or to school life, in order to enable those affected to achieve the greatest possible independence. If necessary, applications for aids or structural changes in your own four walls, for social law measures or for support with care are made during the rehabilitation stay. Familial care courses and nursing courses prepare relatives intensively for the new situation of care at home. If it is not yet possible to return to the home environment after the stay in the clinic, the rehabilitation clinic will organize the placement in an aftercare facility in coordination with the relatives. If necessary, drugs are also prescribed to improve mood.

Of course, they also belong Planning the discharge and first organization of further medical and therapeutic measures for the tasks of rehabilitation. Those affected are supported by the clinic's social service. In addition to semi-inpatient and outpatient offers, repeated inpatient rehabilitation may also be indicated here.

Depending on how bad the cerebral hemorrhage was, it can take several years before the person concerned can take care of himself again. Patience, perseverance, initiative and the support of relatives are strongly required.

In some cases, however, it remains with irreversible residual symptoms. In some cases, permanent home care or even home accommodation is necessary.

On the subject of Fitness to drive of a car in public traffic is not fit to drive for at least three to six months after surgically treated cerebral haemorrhage. In all other cases, an individual decision must be made below.

Last changed on: 07/27/2020

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