Brain hemorrhage symptoms treatment prognosis and rehab

Cerebral hemorrhageBy cerebral hemorrhage doctors mean Different hemorrhages of the human brain. It is therefore Generic term. In the human medical literature a distinction is made between intracranial Hemorrhage (brain bleeding inside the skull), intracerebral Hemorrhages (bleeding that occurs directly in the area of the brain) and extracerebral hemorrhages (meningeal hemorrhages) are distinguished.

Definition: What is a cerebral hemorrhage??

Physicians distinguish between three different cerebral hemorrhages:

From a intracerebral cerebral hemorrhage is spoken when the bleeding directly in the area of the brain occurs. Usually, intracerebral hemorrhages are not caused by traumatic circumstances, such as accidents, but occur suddenly. The characteristic feature of this hemorrhage is its location in the brain tie, the so-called parenchyma. Depending on the cause, intensity and localization of the hemorrhage, a further classification is possible.

In contrast to intracerebral hemorrhages occur intracranial bleeding inside the skull on. Here it can, z. B. after craniocerebral trauma, to hemorrhages between the brain and the skull bone, a epidural hematoma come. Functional consequences occur due to the space. The prere on different brain regions on each.

Extracerebral brain hemorrhage form the third type of hematoma. The literature divides this in turn in two subgroups a. If the affected person develops a hematoma below the meninges, it is called a cerebral hemorrhage Subdural hemorrhage also referred to as a subdural hematoma. In contrast Subarachnoid hemorrhage below the spinal meninges (arachnoid membrane) outside the brain. In this hemorrhage, clustered by vascular bulges (aneurysms) of the blood vessels of the brain, blood is detectable in the cerebrospinal fluid (CSF).

difference between a cerebral hemorrhage and a stroke

bleeding in the head are called cerebral hemorrhages. In a stroke (cerebral hemorrhage), certain areas of the brain are not supplied with sufficient oxygen. There is a lack of blood supply in a stroke but no blood leaks out. A cerebral hemorrhage in an area of the brain (z. B. (e.g., due to an aneurysm) can be the cause of an undersupply of blood to another area of the brain. oxygen and thus trigger a stroke – acute paralysis. In particular, however, a cerebral hemorrhage leads to functional disorders due to the local damage to brain tie and secondarily due to its space-occupying effect and displacement of healthy brain tie. Here, the brain tie can only escape to a limited extent, as it is limited by the rigid skull bone.

cerebral hemorrhage symptoms treatment prognosis and rehabilitation

Symptoms: How to recognize a brain hemorrhage

Cerebral hemorrhages lead to massive impairment of physical integrity. majority of those affected complain of Nausea, vomiting and headaches.

cerebral hemorrhages can accompany a stroke, which is why the typical symptoms The CT and MRI can also indicate a cerebral hemorrhage in the case of a stroke. These are:

– acute paralysis – sudden, severe general malaise and weakness – sudden dizziness and coordination disorders – sudden speech and sensory disturbances – sudden visual disturbances and problems with breathing – acute unconsciousness and disturbances of consciousness

diagnosis of cerebral hemorrhage

Cerebral hemorrhages cannot be diagnosed solely by assigning objective symptoms, because they are not visible externally. Therefore, a reliable diagnosis always requires the performance imaging procedures such as computed tomography (CT), magnetic resonance imaging (MRI) or, less commonly, vascular imaging (angiography).

The standardized initial care usually resorts to a CT image back, as the procedure Results faster than an MRI provides. Both CT and MRI enable the treating physicians to determine the location and size of the cerebral hemorrhage. size changes can be detected by repeating the imaging procedure at a later time.

According to the current state of medicine MRI examinations Indicated primarily when the patient has been stabilized because, unlike a CT scan, an MRI can also visualize older hemorrhages as well as aneurysms or similar malformations.

Course of the disease and prognosis

The course of a cerebral hemorrhage is strongly dependent on the individual case. Major Factors, which massively influence the course of the disease are

– the age, – the general condition, – any underlying diseases, and especially – the location and type of cerebral hemorrhage.

Medical studies have shown that the Mortality rate for minor cerebral hemorrhage between 30 percent and 50 percent (lethality rate) lies. Extensive cerebral hemorrhage is even more likely to lead to death. A large number of patients who survive a cerebral hemorrhage experience long-term to permanent consequential damage as

– paralysis of arm and leg, – speech disorders (speaking and understanding), – disorders of attention, memory and planning ability (sog. neuropsychological disorders) and – further mental or physical impairments.

Treatment of a brain hemorrhage

Cerebral hemorrhages are medical emergencies. Consequently, the time factor plays an essential role in treatment. The longer it takes to initiate adequate treatment, the greater the likelihood of death or of sequelae. In the case of a concrete suspicion of a cerebral hemorrhage, the nearest hospital should therefore be visited immediately, or the patient should be treated in a hospital. the emergency doctor. The clinic should have medical-technical equipment (stroke unit) that enables appropriate diagnosis and treatment.

At the beginning of the acute treatment, the doctors first try to stabilize patients. Since the brain functions of the affected u.a. If the respiratory center is impaired, they often have to be artificially ventilated. If the cerebral hemorrhage results in a Increase in intracranial prere, an operation must be initiated as a matter of urgency. During this surgery, neurosurgeons open part of the skull bone to stop bleeding and remove bruises. To compensate for massive blood loss, the administration of blood units may be necessary.

rehabilitation after acute treatment

Once the patient has overcome the critical phase, the rehabilitative phase begins Long-term treatment. In this case, various measures are initiated to limit the extent of the consequential damage and to prevent further bleeding. Through comprehensive rehabilitation measures, the therapists, nursing staff (therapeutic-activating care) and physicians try to eliminate mental and physical dysfunctions, or to. to limit their effects on the quality of life. The sooner the rehabilitation measure begins in a neurological specialist clinic, the greater the chance of avoiding or reducing the consequential damage of a brain hemorrhage.

During rehabilitation, affected patients are of course given medical care. In addition to the medical consultation and advice, the adapted medication to this.

Our brain controls and monitors physical and mental Functions. Therefore, paralysis, sensory disturbances, but also speech and memory disorders are possible as a consequence. In the Rehabilitation they are intensively examined and treated. The brain remains capable of learning until old age. It is scientifically amed that spared areas of the brain take over tasks and rather slightly damaged regions can even partially recover.

Brain hemorrhages can affect people at any age.

Children and adolescents usually require a special neuropediatric rehabilitation. The still developing body. mind needs therapies suitable for children. caregiver and parents often also require prolonged support in coping with the disease. In a neuropediatric rehabilitation clinic or other facility, they are included in the therapy concept for their children. In some cases, a change of school is necessary in severe cases. As part of the rehabilitation process, children. adolescents also often in a "hospital school teaches.

Achieving the rehabilitation goals

A prerequisite for achieving the rehabilitation goals is targeted Exercise with therapeutic help and to develop a good Self-assessment of the affected person. Since our brain also determines our personality and thus our ability to self-assess, a brain hemorrhage can also lead to a misjudgment of one's own abilities. Therapists, specialized nursing staff and physicians help patients and their relatives to perform the right exercises and develop an appropriate perception of their own strengths and weaknesses.

Modern therapy is carried out by many highly specialized therapists who coordinate intensively and regularly. Occupational therapy, physiotherapy, sports therapy, art and music therapy, speech therapy, balneo-physical therapy, neuropsychology and clinical psychology, garden therapy as well as remedial education/pedagogy are available to assist those affected by the disease.

The therapy uses today if necessary modern Robotics-assisted Devices, for example, to improve walking or arm functions (grasping, etc.).) to improve. Regular repetition helps the brain to relearn lost skills. To improve mental functions (attention, memory, planning ability, problem solving and language), scientifically proven methods are also used, for example in neuropsychology. Modern computer programs are often used for this.

Very important are also Self-exercises of the affected person. Therapists give specific instructions for this – also for self-training after the stay in the clinic.


Severe cerebral hemorrhages alter the Life perspective and planning. Psychologists, social workers and physicians support affected persons and the family in developing perspectives. The primary goal is the return to the family environment, to the workplace or to school life in order to enable those affected to achieve the greatest possible independence. If necessary, applications for aids or structural changes in the patient's own four walls, for socio-legal measures or for support with care are already made during the rehabilitation stay. Familial care training courses and care training intensively prepare relatives for the new situation of care at home. If it is not yet possible to return to the home environment after the hospital stay, the accommodation in an aftercare facility is organized by the rehabilitation clinic in coordination with the relatives. If necessary, medications are also prescribed to improve the moods. Organization of further medical. Therapeutic measures among the tasks of rehabilitation. The clinic's social services provide support for those affected. In addition to partial inpatient and outpatient services, repeated inpatient rehabilitation may also be indicated in this case.

Depending on the severity of the cerebral hemorrhage, it can take several years before the affected person is able to care for himself again independently. Patience, perseverance, initiative, and support from family members are strongly required.

In some cases, however, irreversible residual symptoms remain. In some cases, permanent home care or even institutionalization is then necessary.

On the subject of Fitness to drive a motor vehicle in public traffic is not suitable for driving for at least three to six months after surgically treated cerebral hemorrhages. In all other cases, an individual decision must be made below.

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