Early detection key to surviving brain haemorrhage, says expert

In an interview with The Tribune, Dr Trimaan Singh, Consultant, Neuro-Intervention at Fortis Hospital, Jalandhar, said that survival rates in brain haemorrhage cases can significantly improve with timely intervention and advancements in neuro-interventional treatment.

A brain haemorrhage, often the result of a ruptured brain aneurysm, is among the most critical medical emergencies. Despite its severity, it is frequently mistaken for conditions such as a migraine or stress-induced headache, leading to dangerous delays in treatment. Due to such misjudgements, the condition is often referred to as a "missed" diagnosis.

A brain aneurysm forms when a weak section in the wall of a blood vessel swells outward due to constant blood pressure. While many aneurysms remain small and harmless, a rupture can lead to sudden bleeding inside or around the brain. This internal bleeding, or brain haemorrhage, can begin damaging brain tissue within minutes and is life-threatening if not treated promptly.

The key symptom of a brain haemorrhage is a sudden and extremely severe headache-often described by patients as the worst headache of their lives. Unlike typical headaches, this pain strikes like a bolt of lightning and may be accompanied by nausea, vomiting, drooping eyelids, blurred or double vision, stiff neck, seizures, or sudden loss of consciousness. In some cases, a smaller leak known as a "sentinel headache" may occur before a full rupture. These are often mistaken for less serious headaches, making early recognition and immediate medical attention critical.

Statistics highlight the urgency: nearly half of all patients with a ruptured aneurysm die within the first 24 hours, while many others succumb to complications within three months if untreated. Survivors frequently face long-term effects such as paralysis, speech or memory difficulties and reduced quality of life due to lasting brain damage.

Those at higher risk include individuals between the ages of 30 and 60, with women being more susceptible. Risk factors include uncontrolled high blood pressure, smoking, excessive alcohol intake, drug abuse and a family history of aneurysms.

Modern imaging techniques such as CT scans, MRI and cerebral angiography are crucial for early diagnosis and identifying aneurysms before they rupture. While open brain surgery with a surgical clip was once the only treatment, less invasive methods have now become the global standard. Endovascular therapy-where doctors use thin tubes inserted through arteries to treat the affected vessel from inside-offers safer and more effective options, including coiling and flow diverter placement, to stop blood flow into the aneurysm and prevent re-bleeding.