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July 22, 2021 Thursday 11:18:01 AM IST

Understanding ‘Haemorrhage'

Health Monitor

Nowadays it’s become common news that someone has collapsed and died. The term has become quite relevant to think over the cause of such deaths and alarms us when a person looking healthy suddenly collapses and succumbs to death. The two major causes identified include heart attack and haemorrhage or stroke.

One among the major cause; ‘heart attack’ leads to sudden cardiac arrest. In this scenario, the heart suddenly ceases to function resulting in the blockage of blood flow to the brain and death occurs in no time. There has been sufficient awareness among the public about the symptoms of a heart attack.

The next major cause is identified as ‘haemorrhage’ or ‘stroke’. It occurs when the blood vessel inside the brain gets ruptured and bleeding spreads creating pressure on surrounding brain cells and damage them leading to sudden death. Death can happen even if the major blood vessels in the brain gets completely blocked. Two major causes are identified for bleeding in the brain. ‘Aneurysm’,a weak spot in a blood vessel inside the brain develops to a balloon structure and bursts leading to a haemorrhage. Normally the size of these balloon structures are from 1 to 2 cm. It can form during increased blood pressure, mental stress or sexual activity.

Symptoms of Haemorrhage in Brain

• Sudden and severe headache for no reason. Many patients experience this as the worst headache experienced in their life.

• Vomiting along with headache

• Sensitivity to light

• Stiffness or pain in the neck

• Loss of consciousness with headache

If you notice any of the above symptoms, you should immediately consult a doctor and get the necessary investigations done. Nearly 30% of the patients succumb to death due to haemorrhage in the brain. The remaining one-third of patients face severe complications. Therefore, it is essential to get tested immediately if you experience any of the above symptoms. It is not possible to diagnose vascular disease with a regular CT scan. Brain angiography is recognized as the ideal method to accurately diagnose vascular disease affecting the brain.

Angiography of Brain

Angiography is a procedure that aids in the detailed examination of blood vessels in the brain using X-ray. It is indeed helpful to diagnose the blockages in the blood vessels in various organs and to diagnose aneurysms. To an extent, CT angiography and MR angiography also helps in the diagnosis.

Treatment of Brain Haemorrhage

There are two techniques used to treat haemorrhage caused by an aneurysm.

1. The ruptured part is sealed by clipping with open brain surgery.

2. Pinhole surgery or Coiling treatment

Pinhole Surgery (Coiling treatment)

Endovascular neuro intervention is a treatment technique that involves inserting a thin tube called catheter into an artery through your leg or groin. The procedure is carefully carried out in a Cath lab. The tube is guided through the blood vessels, up into brain and finally to the aneurysm affected part. Doctors use platinum coils of different size and shapes according to the structure of the aneurysm. The size of such coils is less than the width of human hair. Coiling treatment has many advantages over open brain surgery. There is no need to open the skull, which significantly reduces the risk of excessive bleeding. It also reduces the risk of infection. After the procedure, a patient needs to spend a couple of days in the hospital and may return to normal activities within a short duration compared to an open surgery.

The pinhole treatment, which evades open brain surgery, has become a popular choice in Western countries. In western countries, 70% of patients opt for pinhole surgery for stroke. Angiography of brain and pinhole brain surgery (Endovascular Neuro interventions), has been recognised as an ideal treatment modality in the management of haemorrhagic stroke and I gaining popularity in India.

It’s still a question of thought and wonder when we witness a person without any disease collapsing suddenly. However, it’s seen that these individuals often had earlier signs of heart disease or stroke. But lack of awareness and giving less prominence to these indications results in such fatalities. 

Dr. Gigy Varkey Kuruttukulam

Senior Consultant & HOD - Neurology Rajagiri Hospital

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