Dangerous Headaches: Intraparenchymal Hemorrhage

An intraparenchymal hemorrhage is a bleed within the brain tissue. It differs from subdural or epidural hematomas because they occur only in the outer and middle coverings of the brain, whereas an intraparechymal hemorrhage is within the brain itself.

This type of hemorrhage sometimes occurs as an extension of a subdural or epidural hematoma.

Symptoms

Symptoms include:
• Headache
• Nausea and vomiting
• Dizziness
• Changes in vision

• Tingling or "pins and needles"
• Numbness or paralysis in some areas
• Uncoordinated walking
• Inability to talk
• Drowsiness and changes in consciousness
• Difficulty breathing.

What Causes Intraparenchymal hemorrhage?

Trauma can cause intraparenchymal hemorrhage but there are also many other causes such as high blood pressure, brain tumor, bleeding disorders, sickle cell disease, artery malformations and eclampsia of pregnancy. Additional causes are having had a previous cerebral aneurysm or weakened blood vessels, drug abuse and taking blood thinning medication like anticoagulants. Sometimes premature infants may also have this type of brain hemorrhage due to weakened vessels in their head, or infection.

Diagnosis

The condition is diagnosed by a CT scan or MRI of the head. A cerebral angiography may also be done to identify any problems with the blood vessels in the brain. This is when a catheter is placed up through the main blood vessels in the abdomen and up into an artery in the neck.

Then a contrast dye is inserted that travels up to the blood vessels in the brain. This illuminates them on an X-ray picture so that any blockages in the flow of blood can be seen. The patient will be given local anaesthetic to minimize any discomfort they might feel from this procedure.

Treatment

Treatment involves surgery to remove the excess blood, usually by removing part of the skull to drain the blood away. This will decrease the pressure on the brain and lessen the likelihood of permanent brain damage or death. Any bleeding vessels will be tied off.

The patient can also be given medication to reduce brain swelling and anti-convulsants to prevent or treat seizures that are common after a brain injury. If the hemorrhage was caused by high blood pressure, then a blood pressure-lowering medication may be given.

If it was caused by cancer, then the tumors will be removed. The patient will also be given painkillers to ensure they are comfortable after surgery.

Can I prevent intraparenchymal hemorrhage?

No, but there are certain measures you can take to reduce the risk of having one. Eating a healthy diet with plenty of fresh fruit, vegetables and grains and getting regular exercise can help to keep your blood pressure in check.

If you have a blood pressure problem or are taking blood thinning medication on a long-term basis, you should have regular checkups with your doctor so he can monitor your health.

Sources:

Intraparenchymal Brain Hemorrhage, Medicine Online. Web. 21 March 2012. http://www.medicineonline.com/articles/i/2/intraparenchymal-brain-hemorrhage/intracerebral-hemorrhage.html

Intracranial hemorrhage in premature infants: sonographic-pathologic correlation, AJNR 1982 3: 309-317.
Abstract: http://www.ajnr.org/content/3/3/309.abstract

Cerebral Angiography, Medline Plus. Web. 21 March 2012. http://www.nlm.nih.gov/medlineplus/ency/article/003799.htm

Joanna is a freelance health writer for The Mother magazine and Suite 101 with a column on infertility, http://infertility.suite101.com/

She is author of the book, "Breast Milk: A Natural Immunisation", and co-author of an educational resource on disabled parenting.

Reviewed March 21, 2012
by Michele Blacksberg RN
Edited by Jody Smith

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