Stroke- Intracranial Hemorrhage

Intracranial hemorrhage is bleeding in the skull .

Bleeding can occur in the brain or around the brain :
- Bleeding that occurs in the brain called intracerebral hemorrhage
- Bleeding between the brain and the subarachnoid space called the subarachnoid haemorrhage
- Bleeding between the membranes lining the brain ( meninges ) is called a subdural hemorrhage
- Bleeding between the skull and the lining of the brain called epidural hemorrhage .

Any bleeding will cause damage to the brain cells .
The space inside the skull is very limited , so the bleeding will quickly lead to increased pressure and this is very dangerous .

CAUSE

Head injury is the most common cause of intracranial hemorrhage in patients aged under 50 years .

Other causes include arteriovenous malformations , ie anatomical abnormalities in the arteries or veins in or around the arteriovenous otak.Malformasi a congenital abnormality , but only known to
exist if it has caused gejala.Perdarahan of arteriovenous malformations can suddenly cause fainting and death , and tends to strike adolescents and young adults .

Sometimes the walls of blood vessels become weak and prominent , so-called thin aneurisma.Dinding aneurysms can rupture and cause bleeding .
Aneurysms in the brain is the cause of intracranial hemorrhage , which can cause hemorrhagic stroke ( stroke due to bleeding ) .

SYMPTOMS

intracerebral hemorrhage

Intracerebral hemorrhage is a type of stroke , caused by bleeding into the brain tissue .

Intracerebral hemorrhage occurs suddenly , starting with headache , followed by signs of neurological abnormalities ( eg, weakness , paralysis , numbness , impaired speech , impaired vision , and confusion ) . Often occurs nausea , vomiting , seizures and loss of consciousness , that can occur within a few minutes .

Usually done a CT scan and MRI to differentiate ischemic stroke with haemorrhagic stroke .
The examination may also show the extent of brain damage and increased pressure in the brain .

Lumbar puncture is usually not necessary unless there is suspected meningitis or other infections .

Surgery can prolong survival , although leaving berat.Tujuan neurological disorder surgery is to remove the blood that had accumulated in the brain and to relieve pressure inside the skull .

Intracerebral hemorrhage is the most dangerous type of stroke . Stroke is usually widespread , especially in people with chronic high blood pressure . More than half pendeirta who had extensive bleeding , died within a few days .
Patients who survive usually recover partially conscious and brain function again , because the body will absorb the remaining blood .

subarachnoid haemorrhage

Subarachnoid hemorrhage is sudden bleeding into the cavity between the brain and the lining of the brain ( the subarachnoid space ) .

Source of hemorrhage is the rupture of a weak blood vessel walls ( whether an arteriovenous malformation or an aneurysm ) Instantaneous tiba.Kadang atherosclerosis or infection causes damage to the blood vessels so that blood vessels pecah.Pecahnya blood vessels can occur at any age , but most often attack aged 25-50 tahun.Perdarahan subarachnoid rarely occur after a head injury .

Subarachnoid hemorrhage due to aneurysm usually causes no symptoms . Sometimes aneurysm pressing on nerves or small leak before rupture , causing early signs , such as headache , facial pain , double vision , or impaired vision early lainnya.Pertanda can occur within a few minutes to a few weeks before aneurysm rupture . If any of these symptoms should be immediately taken to the doctor in order to take action to prevent heavy bleeding .

Aneurysm rupture usually causes sudden severe headache , which is often followed by a momentary loss of consciousness . Some people develop a coma , but mostly rebuilt , with feelings of confusion and drowsiness .

Blood and cerebrospinal fluid around the brain will irritate the lining of the brain ( meninges ) , and cause headaches , vomiting and pusing.Denyut heart and respiratory rate often up and down , sometimes accompanied by seizures .
Within a few hours or even a few minutes , the patient returned linglung.Sekitar sleepy and 25 % of patients had a neurological disorder , which is usually in the form of paralysis on one side of the body .

Diagnosis is usually made based on the results of a CT scan , which can show the location of perdarahan.Jika necessary , can be performed lumbar puncture to see blood in the fluid serebrospinal.Angiografi performed to confirm the diagnosis and as a guide if surgery .

Approximately one third of patients die in the first episode because of the extent of brain damage .
15 % of patients die within a few weeks after bleeding in a row .
Aneurysm patients who did not undergo surgery and survive , after 6 months had a risk of 5% for the patients perdarahan.Banyak which some or all mental and physical functions back to normal , but neurologic abnormalities sometimes persist .

Patients treated immediately and not allowed to do any strenuous activity .
Pain medication given to treat severe headaches .
Sometimes the drainage hose mounted in the brain to relieve pressure .

Surgery to clog or strengthen a weak artery walls , can reduce the risk of fatal bleeding in later this hari.Pembedahan difficult and very high mortality rate , especially in patients who are comatose or stupor.Sebagian surgeons advocate surgery within 3 days after onset of symptoms . Delaying surgery until 10 days or more to reduce the risk of surgery but increases the likelihood of re-bleeding