$Unique_ID{BRK01360}
$Pretitle{Nervous System and Sense Organs}
$Title{How Does the Doctor Figure out Where Bleeding in the Brain Is?}
$Subject{bleeding CT scan hematoma}
$Volume{F-1}
$Log{
Hypertension*0009601.scf}

Copyright (c) 1991   Tribune Media Services, Inc.


How Does the Doctor Figure out Where Bleeding in the Brain Is?


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QUESTION:  I know that x-rays are useful for making many diagnosis, but I have
been told that they are of little use in diagnosing bleeding in the brain.
But then how does the doctor figure out where the bleeding is, and what can be
done for it if this turns out to be the problem?  We have just bee through a
case like this but are still completely confused.

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ANSWER:  Almost every kind of bleeding with in the brain tissue is called
"intracerebral hemorrhage".  When the blood remains pooled together in a
well-localized superficial location it may be termed a "hematoma".  Before the
development of some incredible technology, particularly the CT scan (computed
tomography) physicians relied on the different clinical patterns and symptoms
that occurred as a result of the bleeding to determine the location.  However
these symptoms might also be caused by the mass effect of the hematoma,
swelling (edema) of the brain from the irritation, the shifting of the brain
as well as the extension of the bleeding to the ventricles (cavities within
the brain) Performing a spinal tap, (withdrawing fluid from the spinal
column), could also reveal the presence of blood, a sure sign of bleeding
somewhere in the central nervous system.  Now the CT scan can localize small
areas of bleeding with excellent precision.  The single greatest cause for
brain hemorrhage is hypertension, and the incidence of hypertension in such
patients ranges from 25 to 94 percent.  The medical treatment may therefore be
directed at lowering the blood pressure, to reduce the amount and possibility
of bleeding.  However once the size of the hemorrhage has reached its maximum,
in about 1 to 2 hours, reducing the blood pressure with do little to reduce
the size of the hemorrhage.  When edema strikes the brain tissue and the
pressure within the skull rises, additional techniques including the use of
corticosteroids may be used.  Finally surgical techniques must be considered
in many cases.  They can be used to remove the accumulated blood (hematoma),
find the area of bleeding and stop the hemorrhage, and finally drain both
blood and fluid away to lower the intracranial pressures.  The decision to
employ surgery will also depend upon other medical factors, and the patients
age and state of health.
ÿ
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The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
