Symptoms of brain bleed after hitting head
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Symptoms of Brain Bleed After Hitting Head
Introduction to Brain Bleeds and Head Trauma
Brain bleeds, or intracranial hemorrhages, can occur after a head injury and are a serious medical condition that requires immediate attention. These bleeds can be classified into different types based on their location, such as epidural, subdural, subarachnoid, and intraparenchymal hemorrhages. Understanding the symptoms associated with brain bleeds is crucial for timely diagnosis and treatment.
Common Symptoms of Brain Bleed
Headache and Migraine
One of the most common symptoms of a brain bleed after a head injury is a severe headache or migraine. This symptom is particularly prevalent in patients with intra-axial bleeds, which include intraparenchymal, subarachnoid, or intraventricular hemorrhages. Studies have shown that patients with intra-axial bleeds report higher headache/migraine scores compared to those with extra-axial bleeds, such as epidural or subdural hematomas.
Cognitive and Ocular-Motor Disturbances
Cognitive impairments and ocular-motor disturbances are also significant symptoms observed in patients with brain bleeds. These symptoms can include difficulties with concentration, memory, and visual tracking. Patients with intra-axial bleeds tend to exhibit more severe cognitive and ocular-motor symptoms compared to those with extra-axial bleeds.
Vestibular Symptoms
Vestibular symptoms, such as dizziness and balance issues, are another common manifestation of brain bleeds. These symptoms are more pronounced in patients with intra-axial hemorrhages. The severity of vestibular symptoms can vary, but they are generally more significant in patients with intra-axial bleeds compared to those with extra-axial bleeds.
Sleep Disturbances
Sleep disturbances are frequently reported by patients who have suffered a brain bleed. These disturbances can include difficulty falling asleep, staying asleep, or experiencing restful sleep. Age has been found to be a contributing factor to sleep disturbances in patients with brain bleeds.
Hemostatic Disruptions and Secondary Symptoms
Coagulation Issues
Following a traumatic brain injury (TBI), patients often experience disruptions in the coagulation cascade, leading to either excessive bleeding or a prothrombotic state. In the initial hours after the injury, patients may exhibit hyperfibrinolysis and impaired clot formation, which can contribute to the progression of the hemorrhagic lesion. This can result in secondary symptoms such as increased intracranial pressure and further neurological decline.
Hemorrhagic Progression of Contusion (HPC)
Hemorrhagic progression of a contusion (HPC) is a phenomenon where the initial hemorrhagic lesion expands or new hemorrhagic lesions develop within hours after the injury. This progression is often due to continued bleeding from microvessels damaged during the primary injury and can lead to severe secondary brain damage. Symptoms associated with HPC include worsening headaches, increased confusion, and neurological deficits.
Special Considerations in Infants
Subdural Bleeding in Infants
In infants, subdural bleeding (SDB) is a critical symptom often associated with nonaccidental head injury (NAHI). SDB in infants can present with symptoms such as irritability, vomiting, lethargy, and seizures. It is important to note that SDB is more commonly linked to traumatic causes, including NAHI, rather than hypoxia or brain swelling.
Conclusion
Recognizing the symptoms of a brain bleed after a head injury is essential for prompt medical intervention. Common symptoms include severe headaches, cognitive and ocular-motor disturbances, vestibular symptoms, and sleep disturbances. Hemostatic disruptions and the progression of hemorrhagic contusions can further complicate the clinical picture. Special attention should be given to infants, where subdural bleeding is often indicative of nonaccidental trauma. Early diagnosis and treatment are crucial to mitigate the severe consequences of brain bleeds.
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