Hemorrhage

Hemorrhage (HEM-or-ij) is bleeding or the escape of blood from the blood vessels. The term hemorrhage usually refers to significant bleeding.

What Causes Hemorrhage?

Hemorrhage is any profuse internal or external bleeding from the blood vessels. The most obvious cause of hemorrhage is trauma or injury to a blood vessel. Hemorrhage can also be caused by aneurysms or weak spots in the artery wall that are often present at birth. Over time, the blood vessel walls at the site of an aneurysm tend to become thinner and bulge out like water balloons as blood passes through them, making them more likely to leak and rupture.

Hypertension, or high blood pressure, is often a contributing factor in brain hemorrhage, which can cause a stroke. Other times, vessels simply wear out with age. Uncontrolled diabetes can also weaken blood vessels, especially in the eyes; this is called retinopathy (ret-i-NOP-a-thee). Use of medications that affect blood clotting, including aspirin, can make hemorrhage more likely to occur.

Bleeding disorders can also spark hemorrhages. Among them are hemophilia (he-mo-FIL-e-a), an inherited disorder that prevents the blood from clotting.

How Can You Spot a Hemorrhage?

Visible blood is the most obvious sign, but sometimes the only way to know a hemorrhage has occurred inside the body is when it causes symptoms or an illness, such as a stroke. In the case of a brain hemorrhage, depending on where the bleeding is occurring, symptoms can include headache; loss of function on one side of the body; vision changes; numbness or weakness; difficulty speaking, swallowing, reading, or writing; balance problems; decreased alertness; vomiting; stiff neck; and confusion, drowsiness, or coma.

People with hemophilia often experience a tingling feeling that alerts them to a hemorrhage.

How Is a Hemorrhage Diagnosed?

When bleeding is visible, the causes of most hemorrhages are obvious. Blood tests and spinal fluid tests can show evidence of brain hemorrhage. Computed tomography (CT or CAT) scanning is an important imaging test used to evaluate the brain and other tissues to see if bleeding has occurred.

How Is a Hemorrhage Treated?

The first goal in treating a hemorrhage is to stop the bleeding. Hemorrhage caused by trauma or the tearing of blood vessels can be treated by clamping or surgically repairing the tears. Hemorrhage resulting from vessel leakage due to high blood pressure can be treated with medicines to reduce blood pressure, prevent vessel spasm, and reduce pain. Surgery may be needed to reduce the pressure of collected blood in the brain. Blood factors to help the blood clot may be administered to those with bleeding disorders.

How Can Hemorrhage Be Prevented?

A healthy diet, regular exercise, cutting down on excess sodium intake, maintaining a normal weight, and taking prescribed medication properly can often control high blood pressure. Avoiding drug use can also help prevent brain hemorrhage. Cocaine, amphetamines, and alcohol are increasingly associated with brain hemorrhages, particularly in young people. Wearing helmets when bicycling, skateboarding, and rollerblading and always wearing seatbelts in motor vehicles can help prevent serious head injuries. Retinopathy can be prevented or lessened by good control of diabetes, that is, keeping blood sugars at near-normal levels.