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.
Intracranial hemorrhage
Intracranial hemorrhage is defined as condition of bleeding within the skull.
D.1.1. Types of Intracranial hemorrhage
In the study to evaluate the sensitivity and specificity of head ultrasound (HUS) in the detection of intracranial hemorrhage
in premature neonates compared with brain MRI using
susceptibility-weighted imaging (SWI), showed that Ultrasound (US) and
MRI scans of the brain using SWI in premature
neonates were retrospectively evaluated for grade I-III germinal matrix hemorrhage (GMH), periventricular hemorrhagic infarction (PVHI), intra-axial hemorrhage other than PVHI, extra-axial hemorrhage in each cerebral hemisphere and cerebellar hemorrhage in each cerebellar hemisphere(1).
1. Intra-axial hemorrhage (cerebral hemorrhage)
Intra-axial hemorrhage is defined as a condition of bleeding in the
brain itself, including bleeding of the brain tissues and ventricles,
2. Extra-axial hemorrhage
Extra-axial hemorrhage is defined as a condition of skull bleeding outside of the brain
Symptoms
1. Intracranial pressure
Intracranial pressure as a result of a traumatic brain injuries can cause large mass which puts pressure on the brain(13).
2. Severe headache followed by vomiting is one of the more common symptoms of intracerebral hemorrhage, a sub types of Intracranial hemorrhage(14).
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(15).
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
1. According to the study of Risk factors for intracranial
hemorrhage and nonhemorrhagic stroke after fibrinolytic therapy (from
the GUSTO-i trial), showed that Of 592 patients in the Global
Utilization of Streptokinase and tPA for
Occluded Arteries-I trial who had a stroke during initial
hospitalization, the risk for intracranial hemorrhage was significantly
greater in those with recent facial or head trauma (odds ratio 13.0, 95%
confidence interval 3.4 to 85.5); dementia was additionally associated
with an increased risk for intracranial hemorrhage (odds ratio 3.4, 95%
confidence interval 1.2 to 10.2). Because facial or head trauma may
greatly influence treatment decisions, this risk factor should be
incorporated into models designed to estimate the risks and benefits of
fibrinolytic therapy(12).
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Sources
(12) http://www.ajconline.org/article/S0002-9149%2803%2901581-9/abstract
(13) http://emedicine.medscape.com/article/247664-overview
(14) http://en.wikipedia.org/wiki/Cerebral_hemorrhage
(15) http://www.ncbi.nlm.nih.gov/pubmed/21234617
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