ABOUT BRAIN HAEMORRHAGES

A brain haemorrhage, or a Haemorrhagic stroke, is when you have bleeding in or around the brain. 4.6 million people suffer from a brain haemorrhage every year.

(Source: World Stroke Organisation)

There are two main types of haemorrhagic stroke:

1/ INTRACEREBRAL HAEMORRHAGE (or ICH)

This is when there is bleeding within the brain: Blood leaks out of a blood vessel into the brain tissue, sometimes deep inside the brain.

This is the most common type of haemorrhagic stroke. 

There are approximately 3.4 million cases of ICH every year. (Source: World Stroke Organisation)

2/ SUBARACHNOID HAEMORRHAGE (or SAH)

This is when there is bleeding on the surface of the brain: Blood leaks out of a blood vessel on the surface of the brain, and gets between the layers of protective membranes that surround the brain, cushioning it from injury (the subarachnoid space).

This is the least common type of stroke, and around 1/3 of all haemorrhagic strokes are SAH (about1/20 of all strokes). 

There are approximately 1.2 million cases of SAH every year. (Source: World Stroke Organisation)

A HAEMORRHAGIC Stroke, is when you have bleeding in or around the brain and accounts for around 15% of strokes in the UK.

Whereas a ISCHAEMIC Stroke is due to a blockage in the blood supply to the brain. This type of stroke accounts for around 85% of strokes.

(Source: Stroke Association)

Haemorrhagic strokes can have different causes but there are some things that can make you more likely to have a haemorrhagic stroke, such as high blood pressure, and a build-up of fatty material in your arteries. 

Main causes of Intracerebral haemorrhage

Cerebral small vessel disease: This is when there is damage to very small blood vessels in your brain. This can lead to blood leaking into the brain tissue, often deep inside the brain. High blood pressure is the leading cause of small vessel disease in the brain, over a long period, high blood pressure damages the blood vessels inside your brain reducing blood flow to your brain cells and can cause brain haemorrhages.

Abnormal blood vessels in the brain

Rare abnormalities in the blood vessels of the brain can sometimes cause ICH. These are known as vascular malformations, and they can include tangles of blood vessels or enlarged blood vessels. There are two main types: 

Arteriovenous malformation (AVM). In an AVM, the blood vessels carrying blood to and from the brain grow together in a tangle, instead of linking to the full network of smaller blood vessels in the brain. An AVM can reduce blood flow and compress the surrounding brain tissue. Inside the AVM, blood flows at high pressure into weak blood vessels, which can sometimes lead to bleeding. 

Cavernous malformation, or cavernoma. A cavernoma is a cluster of enlarged blood vessels, often said to look like a raspberry. It is made up of a series of connected ‘bubbles’ or caverns, filled with blood. Often these don’t cause any symptoms, but the blood vessel walls can be weak, making a bleed more likely. 

Main causes of Subarachnoid Haemorrhage

SAH is often due to a burst aneurysm. But what is A brain aneurysm?

An aneurysm is a bulge in a blood vessel The walls of an aneurysm are weak, and they sometimes burst as the blood passes through the vessel, causing bleeding into the layer of fluid around the brain.

More than 8 out of every 10 subarachnoid haemorrhages happen in this way.

A brain aneurysm doesn't usually cause any symptoms unless it ruptures. But some people with unruptured aneurysms experience symptoms such as: sight problems, pain on one side of the face or around the eye, persistent headaches.

Exactly what causes the wall of affected blood vessels to weaken is still unclear, although risk factors have been identified. These include:  smoking, high blood pressure, a family history of brain aneurysms.

In some cases, an aneurysm may develop because there was a weakness in the walls of the blood vessels at birth.

Around 1 in 15,000 people have a ruptured brain aneurysm in England each year.

Brain aneurysms can develop in anyone at any age, but are more common in people over the age of 40. Women tend to be affected more commonly than men.

The best way to prevent a Hemorrhagic Stoke, or reduce the risk of an aneurysm growing bigger and possibly rupturing, is to avoid activities that could damage your blood vessels, such as smoking, eating a high-fat diet, not controlling high blood pressure, being overweight or obese.

PREVENT THE PREVENTABLE: Check your blood pressure

Not all brain haemorrhages are preventable. But many are caused due to unhealthy lifestyle and according to STROKE UK Hyper tension (high blood pressure), is the biggest cause of lifestyle related brain haemorrhages. We want to educate people about brain haemorrhages, to prevent as many lifestyle related brain haemorrhages from happening as possible. This is why we are running our ‘CHECK YOUR BLOOD PRESSURE’ Campaign.

Read more about PREVENTING BRAIN HAEMORRHAGES and managing your blood pressure Here.

Time is critically important when someone has had a brain haemorrhage. The most typical symptom of a haemorrhagic stroke is a sudden, severe headache, sometimes called a thunderclap headache. Other common symptoms are a stiff neck, nausea and vomiting.

• You can also have any of the signs of stroke in the FAST test:

• Facial weakness: Can the person smile? Has their mouth or eye drooped?

• Arm weakness: Can the person raise both arms?

• Speech problems: Can the person speak clearly and understand what you say?

Time to call 999: if you see any of these signs.

If in any doubt, please phone 999 immediately.

Depending on the cause, the size of the bleed, the amount of pressure built up, as well as other factors e.g. blood pressure, age etc, the treatment will vary, but could include surgery on the affected area and/or medication.

Spontaneous bleeding in the brain is responsible for around 1 in 10 strokes and affects around 10,000 people in the UK every year and there are a few different causes for intracerebral haemorrhage - find out more here.

Life after a brain haemorrhage is a journey that’s different for everyone, which brings a lot of uncertainty. Can a brain haemorrhage can be treated? And can you fully recover? Read here to learn more about the facts on survival, what recovery looks like, and highlight what’s being done to help patients.