Brain haemorrhage

“I think Peter Bullock is one of the most engaging, constructive and reassuring doctors I have ever met.”

Gianpaolo, subdural haematoma patient

A brain haemorrhage is a brain bleed, where a blood vessel gives way and causes bleeding into or around the brain. This may occur as a result of a stroke or a head injury.

The London Clinic also deals with other causes of brain haemorrhage such as aneurysms, AVMs and cavernomas.

Aneurysm

A brain aneurysm is a balloon-like bulge in the wall of a blood vessel in the brain. Small ones often causes no symptoms – indeed they may only be discovered when you’re undergoing treatment for something else. But when symptoms do occur, they may be things like problems with your peripheral vision, speech, balance or ability to think – this usually occurs when the aneurysm has grown very large.

Only 1-2 per cent of aneurysms burst in any given year, but it is an emergency situation if one does, so if you are diagnosed with an aneurysm, every effort will be made to treat it before it reaches a critical stage.

The most frequent treatment carried out by The London Clinic is coil embolisation. A small tube is inserted into the affected artery and miniature platinum coils are moved through the tube into the aneurysm, relieving pressure and making it less likely to rupture. More than 125,000 patients worldwide have been treated with detachable platinum coils and because it is not a very invasive procedure, many patients go home soon after the embolisation.

Another treatment available is surgical clipping, which involves placing a small metal clip around the base of the aneurysm to cut it off from the normal blood supply. This procedure is more invasive, so whether it can be carried out depends on the location and size of the aneurysm, and your general health. Most patients spend two or three days in hospital after a clipping procedure

AVM

AVM stands for arteriovenous malformation – an abnormal connection between the arteries, veins and capillaries in the brain, which form a tangled mass. Most doctors believe that AVMs form before a person is born. Only 1-3 per cent of AVMs rupture in any given year, but if one does, it can cause symptoms similar to those of a stroke.

AVMs can be detected before they burst, because they can cause a wide range of symptoms such as tinnitus (ringing in the ears), numbness and headache. Some are also picked up in the course of routine scanning.

Depending on their size and their location in the brain, AVMs can be treated with conservative medical therapy, surgery or radiosurgery. They can be shrunk using GammaKnife® or CyberKnife®, which is particularly useful for small AVMs deep in the brain, which are difficult to remove by conventional surgery.

Cavernoma

A cavernoma is a small cluster of abnormal blood vessels that fills up with venous blood and looks something like a blackberry. Because the blood comes from the veins rather than the arteries it is a low pressure and many people don’t have symptoms – the cavernoma may only be found in the course of a scan for something else. But if a cavernoma bleeds, it can give rise to seizures or signs like those of a small stroke. Symptoms may also come and go as the cavernoma bleeds, then the blood is reabsorbed.

At The London Clinic, cavernomas are usually treated by excision – ie: they are cut out. See case study on Sammy.