Brain Hemorrhage (Hemorrhagic Stroke)

A brain hemorrhage refers to bleeding that occurs in the skull, inside or outside the brain. Uncontrolled bleeding reduces the flow of oxygen to the brain, causing brain damage.

To diagnose this emergency condition, the Houston Methodist stroke team will perform a physical exam and obtain a medical history, if possible. We will order rapid blood testing and imaging to verify whether a hemorrhagic stroke   has occurred, and if so, what type. The types of hemorrhagic stroke differ according to where they occur and what caused them:

• Intracerebral hemorrhages bleed into the surrounding brain tissue and are usually caused by high blood pressure, trauma, blood-thinning medications or arteriovenous malformation (AVM), a congenital condition resulting in an abnormal connection between arteries and veins.
• Subarachnoid hemorrhages bleed into the space between the brain surface and skull. They are usually caused by the rupture of an aneurysm.

Brain hemorrhages usually occur suddenly and can be due to varying circumstances or health conditions, such as a hit to the head, a ruptured aneurysm, a brain tumor, high blood pressure or a blood clot. Unlike other causes of head pain, a brain hemorrhage causes multiple symptoms to appear simultaneously, such as:

• Confusion or problems with speaking or understanding speech
• Dizziness or loss of balance
• Numbness or weakness on one side of the body
• Problems with seeing in one or both eyes
• Problems with walking or loss of coordination
• Severe headache

If you think someone is having a brain hemorrhage, think FAST to reduce the risk of long-term complications caused by stroke:

• Face – Does the face look uneven? Ask the person to smile.
• Arms – Does one arm drift down? Ask the person to raise both arms.
• Speech – Does his or her speech sound strange? Ask the person to repeat a simple phrase.
• Time – If you observe any of these signs, call 911 immediately.

The sooner we can diagnose the type of stroke, the faster we can begin treatment. Houston Methodist provides expert neurocritical care 24/7 for top-tier, immediate stroke intervention and care.

The goal of emergency brain hemorrhage treatment is to control the bleeding and reducing pressure in the brain:

• If you take drugs to prevent blood clots (warfarin), you may receive drugs or blood product transfusions to counteract their effects.
• You may receive medications to decrease intracranial pressure in the brain, lower blood pressure, prevent vasospasm (spasm of blood vessels due to loss of blood) or prevent seizures.

Once the bleeding stops, we provide supportive medical care while your body absorbs the blood. Surgical treatment options for a hemorrhagic stroke depend on the location, cause and extent of bleeding:

• Surgical clipping can keep an aneurysm from rupturing, preventing a second round of bleeding.
• Coiling (or endovascular embolization) involves placement of tiny detachable coils into the aneurysm, which fills the aneurysm and blocks blood flow, causing the blood to clot.

After emergency treatment, comprehensive stroke care focuses on helping you regain strength, recover as much of your previous function as possible and return to independent living. We will coordinate your physical therapy, whether it occurs on an outpatient basis, at home or in a short-term rehabilitation facility.

After a brain hemorrhage, long-term specialized care can help patients recover certain functional deficits and regain greater independence. If you are uncertain about your next steps or if your current rehabilitation plan is unsatisfactory, our hemorrhagic stroke specialists can provide a personalized consultation.

Houston Methodist’s interdisciplinary stroke team can help you achieve the best outcomes and return to a more comfortable, higher quality life.