It seems this particular physical condition has been a plague to Hollywood. Recent cases that have led to the deaths of Gary Coleman, Natasha Richardson and John Ritter and has caused countless scary problems for Celebrity Apprentice winner Bret Michaels. So what is intracranial hemorrhage and why does it have such a high fatality rate?
Medicine is filled with Greek and Latin words and this little phrase is no exception. The prefix intra is Latin for within and cranial refers to of or relating to the skull. A hemorrhage of any kind is a leak of blood into surrounding tissues. So an intracranial hemorrhage is a blood leak somewhere in the skull. It can occur due to an externally initiated trauma like crashing into a tree while skiing or it can be internally initiated by a ruptured aneurysm. Aneurysms are blood vessels that have a structural defect like a bulge. This bulge over time weakens the vessel such that it actually bursts.
To help out with the gaps in my own memories of anatomy and perhaps yours too, I did a bit of a refresher on how blood moves through the body. The lungs exchange carbon dioxide for oxygen using hemoglobin as a means of carrying the oxygen through the blood. Since the heart wants to move only the oxygenated blood to the whole of the body, it sends blood first to the lungs via the right ventricle. Once the oxygenated blood is returned to the heart through the left atrium, it is sent to the left ventricle to be pumped to the whole of the rest of the body via the aorta. This begins the longest pressurized route the blood will take and because of this the aorta is the largest of the arterial structures. It has to be large to withstand the pressure of that large volume of blood being sent all through the body.
Once the blood has reached all of the tissues, via arteries that split off to reach all the body parts and become smaller arteries (arterioles) and then capillaries (the smallest vessels in the blood system that accesses all tissues of the body) that exchange fresh oxygenated blood for spent blood found in the tissues (blood with less oxygen and various tissue / cellular waste products) the blood then travels to the venous system. The veins closest to the capillaries are very small then grade up to larger vessels as they join up with veins from other areas of the body on the return trip to the heart. They have very little in the way of structural support and rely instead on a combination of the surrounding muscle and the flow of blood initiated by the left ventricle to move the deoxygenated blood back to the right atrium of the heart to start the cycle of blood flow over again. This is the reason that most aneurysms occur in arteries – they experience more pressure.
What makes these intracranial hemorrhages so deadly? The extra blood (no longer contained in the vessels and pouring out into the brain cavity) increases the pressure in the skull (because it is a fixed size) which then can crush brain structures and disrupt normal brain blood flow. The brain is so important to the body that regardless of what is happening in the body it takes the glucose and oxygen first. Part of the problem with brain injury is that there are structures and glands in the brain that control essential body functions like breath rate, heart rate, sleep, awareness, sex hormones, stress hormones, pretty much everything that keeps life going in a direct or indirect way. So that’s the how but what is the why with respect to the seemingly high numbers of intracranial hemorrhages lately? I know I don’t have an answer. I do know that most people do not eat as well as they think they do. That many people do not have enough trace minerals in their diet and that minerals like copper are needed to make certain essential metabolic enzymes work. Is this enough of a why – I don’t know. I do know that I’ll be keeping my eyes and ears open for a more complete answer.
