BRAIN BLEEDS
A Patient-Centered Website on the Types, Causes, Prevention and Management of Brain Bleeds
TYPES OF BRAIN BLEEDS
Brain bleeds (Intracranial Hemorrhages, ICH) can be classified based on the brain compartment involved and the cause:
1- Bleeding into brain tissue (Hemorrhagic stroke, Intracerebral hemorrhage, Intraparenchymal hemorrhage, IPH): the most common type, mostly due to small vessel diseases of the brain in older adults but many less common causes exist. Most common small vessel disease related hemorrhages are:
Cerebral Amyloid Angiopathy (CAA)
2- Primary Intraventricular Hemorrhage: bleeding inside the ventricles, i.e. spinal fluid containing spaces in the brain
3- Bleeding inside the coverings of the brain
Subarachnoid hemorrhage (SAH) -> 85% related to aneurysms (balooning) of brain arteries
Subdural hemorrhage (SDH) -> either related to trauma OR "chronic, spontaneous" in older adults
Epidural hemorrhage (EDH) -> mostly related to trauma, rare but very severe type
4- Smaller hemorrhagic pathologies visible especially on brain MRI
Microbleeds -> very small amount of "oozing" from the small vessels of the brain, visible on special MRI sequences (SWI or GRE)
Superficial siderosis -> small layer of very superficial bleeding, visible on MRI, mostly seen in CAA
5- Other, non-bleeding pathologies that might signal a higher risk of brain bleeding
White matter disease -> probably related to inadequate flow to deeper brain regions, related to the small vessel diseases that also cause bleeding (CAA, hypertensive)
Lacunar infarcts -> small deep infarcts that commonly cause stroke symptoms (3-15mm diameter)