Bleeding (hemorrhage) inside the skull, also called the cranium (intracranial) is a serious medical emergency—if you suspect an intracranial hemorrhage get immediate treatment. Intracranial hemorrhages can develop between the skull and the brain or within the brain tissue:

• Intracerebral hemorrhage — A cerebral hemorrhage is bleeding within or around the brain tissue. The blood may pool forming a blood clot or hematoma.
• Hemorrhagic stroke — If the bleeding originates from burst or leaking arteries in the brain, it is considered a hemorrhagic stroke.

Causes of Intracranial Hemorrhage

Intracerebral hemorrhages in children are generally caused by abnormal vascular formations or blood clots. Adults or children may acquire an intracranial hemorrhage from a range of causes:

• Head injury — Vehicular accidents, falls, sports injuries, or trauma due to violence
• Arteriovenous malformations — Cerebral AVMs consist of an abnormal network of veins and arteries in the brain that cause blood pooling in the brain.
• Cerebral aneurysms — Brain aneurysms can burst causing blood to leak out of the blood vessel wall.
• Moyamoya disease — The narrowing of the carotid during Moyamoya disease and the development of additional blood vessels may cause bleeding in the brain tissue.
• Other abnormal vascular formations — Arteriovenous fistula and cavernous malformation may also cause intracranial hemorrhages.
• Vascular tumors — Certain tumors in and around the brain can also cause bleeding in the skull.

Adults are more likely to have an intracranial hemorrhage caused by hypertension.

Symptoms of Intracranial Hemorrhage

Intracranial hemorrhage symptoms occur due to the lack of oxygen to the brain cells leading to the cells’ death and the disruption of nerve cell function — causing a stroke.

Often symptoms can be relegated to one side of the body or face such as

• Weakness and numbness
• Problems with speech
• Blurred vision
• Paralysis

Head injury symptoms may be immediate or can take weeks to form. Other symptoms may include

• Headache
• Confusion
• Personality shifts
• Nausea and/or vomiting
• Seizure
• Lethargy
• Loss of consciousness

If your symptoms are indicative of an intracranial hemorrhage, seek emergency medical services right away.

How Are Intracranial Hemorrhages Diagnosed?

Diagnosis of an intracranial hemorrhage will begin in the emergency room, including a review of your medical history, a physical exam, your symptoms, and your current medications. Diagnostic testing may include:

• Non-invasive scans such as magnetic resonance imaging (MRI) and computed tomography angiography provide images of your brain’s structures.
• An angiogram or other advanced imaging techniques may be used to take images of your brain’s blood vessels. A contrast dye may be used if tumors or malformations of the vascular system are suspected.

State-of-the-Art Treatments for Intracranial Hemorrhage at NSPC in NY

Depending on the cause, size and location of the bleeding, and other factors, patients may be treated medically or in combination with endovascular techniques and surgical procedures to halt the bleeding, remove the hematoma and alleviate pressure on the brain.

• Medications may help curb blood pressure.
• Surgical treatment is employed to clear away the hematoma and to repair the source of bleeding. Decompression surgery alleviates the pressure on the brain from the blood that has collected.
• Stereotactic aspiration is used for larger pools of blood extending farther down into the brain.
• Surgical clipping or aneurysm coiling techniques may be used for ruptured aneurysms.

No one treatment covers all intracranial hemorrhages. Our highly trained neurosurgeons and interventional radiologists work together as part of a leading multidisciplinary team. At our Long Island and New York locations, you will have a team of brain specialists to provide the most advanced cerebrovascular and neurosurgical techniques treatment of intracranial hemorrhage, including intracerebral hemorrhages and ischemic strokes.