Surgery for Intracranial Hemorrhage

Patients can develop an intracranial hemorrhage for a variety of reasons. These are seen as a result of traumatic and non-traumatic causes. The most common cause of a hemorrhage within the brain itself is a hemorrhagic stroke. These are typically not treated surgically. Hemorrhages can occur, however, as a result of bleeding from an underlying vascular abnormality or underlying tumor. These types of hemorrhages may require surgical treatment and resection.

Hemorrhage can also occur outside of the brain—either above the dura covering the brain (epidural) or below the dura (subdural). Most commonly, these bleeds occur as a result of trauma. A traumatic head injury can result in not only injury to the brain, but also injury to the blood vessels, causing a hemorrhage.

Often, surgical removal of the hemorrhage is needed. Patients can also develop subdural hematomas without trauma. Most commonly, this will occur in elderly patients, especially if they have been on any sort of blood thinners. These patients develop a “chronic” subdural hematoma and tend to have a slow decline in mental functioning. They often experience increasing confusion and gait (walking) problems. Surgery may be needed to relieve the pressure on the brain. How well the patient does following surgery often depends on the degree of underlying brain injury associated with the hemorrhage and not on the bleeding itself.


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