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Monday, 2 December 2013

Upper head hemorrhaging: Cerebral hemorrhage - The Symptoms and Risk Factors

Hemorrhaging is also known as bleeding or abnormal bleeding as a result of blood loss due to internal.external leaking from blood vessels or through the skin.
Cerebral hemorrhage
Cerebral hemorrhage, a sub type of intracranial hemorrhage, is defined as a condition of  bleeding as a result of artery bursts in the brain, considered as one of the main cause of stroke, according to the research article of Endoscopic management of hypertensive intraventricular haemorrhage with obstructive hydrocephalus(1).

D.2.2. Symptoms 
1.  Intracranial pressure
Intracranial pressure as a result of a traumatic brain injuries can cause large mass which puts pressure on the brain(9).

2. Severe headache followed by vomiting is one of the more common symptoms of intracerebral hemorrhage, a sub types of Intracranial hemorrhage(10).

3. Seizures with no previous history of seizures
In the study to determine the outcome and prognostic factors in those patients with severe AVM-ICH, showed that there were seven males and nine females with a mean age of 32 years (range 6-66). All had Glasgow coma score 8 or less and most exhibited motor posturing and/or dilated pupils. Fifteen patients had intraprenchymal, ten had intraventricular, and four had subarachnoid hemorrhage (SAH). Twelve patients underwent hematoma evacuation with concomitant decompressive craniectomy in 11 and external ventricular drainage (EVD) in six. EVD was the only treatment offered to four patients. AVM excision was not routinely attempted in the acute phase. Three patients died from extensive bihemispheric infarction and refractory intracranial pressure. All 13 survivors improved neurologically and 12 had an acceptable functional outcome (modified Rankin scale ≤ 4) after a mean follow-up of 10 months (range 1-49). Among all clinical, radiological, and operative variables, only cisternal SAH (P = 0.007) and early seizures (P = 0.018) were significantly associated with death(11).

3. Other symptoms as a result of central nervous system has been affect by intracranial hemorrhage, such as weakness in an arm or leg, decreased alertness, tingling or numbness, difficulty writing or reading, loss of motor tremors, loss of balance, etc.

Risk factors 
In the study of a total of 1714 patients with hemorrhagic stroke  participation in the Hemorrhagic Stroke Project (HSP), showed that of these, 217 cases met the criteria for primary ICH. Cases with primary ICH were matched to 419 controls. Independent risk factors for ICH included hypertension (adjusted odds ratio [OR], 5.71; 95% CI, 3.61 to 9.05), diabetes (adjusted OR, 2.40; 95% CI, 1.15 to 5.01), menopause (adjusted OR, 2.50; 95% CI, 1.06 to 5.88), current cigarette smoking (adjusted OR, 1.58; 95% CI, 1.02 to 2.44), alcoholic drinks≥2/day (adjusted OR, 2.23; 95% CI, 1.16 to 4.32), caffeinated drinks≥5/day (adjusted OR, 1.73; 95% CI, 1.08 to 2.79), and caffeine in drugs (adjusted OR, 3.55; 95% CI, 1.24 to 10.20)(8). 
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Sources
(1) http://www.biomedcentral.com/1471-2377/7/1
(8) http://stroke.ahajournals.org/content/36/9/1881.abstract
(9) http://emedicine.medscape.com/article/247664-overview
(10) http://en.wikipedia.org/wiki/Cerebral_hemorrhage
(11) http://www.ncbi.nlm.nih.gov/pubmed/21234617