How is intracranial hemorrhage treated?

Any type of bleeding inside the skull or brain is a medical emergency. It is important to get the person to a hospital emergency room immediately to determine the cause of the bleeding and begin medical treatment.

If a stroke has occurred, the cause (bleeding or blood clot) must be determined so that the appropriate treatment can be started. Prompt medical treatment can minimize damage to the brain, thereby improving the patient's chance of recovery.

Surgery may be necessary in the following situations:

  • Hemorrhage may require immediate decompression of the brain to release pooled blood and relieve pressure. Decompression may be done through a burr hole procedure (drilling a hole in the skull to allow blood drainage), a craniectomy incision (partial removal of the skull to allow the swelling brain to expand), or a craniotomy (opening of the skull cavity).
  • Hemorrhage caused by a ruptured cerebral aneurysm requires clipping of the aneurysm through a craniotomy surgical procedure, as soon as the patient's neurological condition permits.

Other treatments may include:

  • Anti-anxiety drugs and/or medication to control blood pressure
  • Anti-epileptic drugs for seizure control
  • Other medications necessary to control other symptoms, such as painkillers for severe headache and stool softeners to prevent constipation and straining during bowel movements
  • Nutrients and fluids as necessary- These may be given through a vein (intravenously), or a feeding tube in the stomach (gastronomy tube), especially if the patient has difficulty swallowing

What does long-term treatment of intracranial hemorrhage include?

The goals of long-term treatment are to help the patient regain the functions necessary for daily living, as much and as soon as possible, and to prevent future intracranial hemorrhages. Rehabilitation and recovery time vary according to each individual's condition and the extent of rehabilitation possible.

Long-term rehabilitation treatment may include:

  • Physical therapy
  • Speech therapy, or alternative forms of communication
  • Occupational therapy
  • Lifestyle changes to reduce risk of another hemorrhage

Last reviewed by a Cleveland Clinic medical professional on 10/25/2016.

References

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