The Basics About Brain Bleeds / Hemorrhages
A hematoma is a collection of blood outside the brain. A subdural hematoma results from blood collecting between the outermost layer of the brain, also known as the dura, and the next layer called the arachnoid. An epidural hematoma refers to the bleeding between the dura matter and the skull. Hematomas can result in excess pressure and/or swelling of the brain, and in the worst cases can lead to death.
How Is Traumatic Brain Injury Diagnosed
Diagnosis of traumatic brain injury is often based on history, assessment of the persons loss of consciousness, a detailed neurological exam and imaging studies.
Neuropsychological testing is the most sensitive means of identifying dementia in persons with a head injury. Its carried out by a specialist trained in clinical psychology and uses clinical rating scales to identify subtle cognitive issues. This testing also establishes clear baselines for measuring changes over time.
Head injury warrants a brain scan to determine whether any brain structures show physical abnormalities:
- CT scan is the standard test for a person with a head injury. A scan performed one to three months after injury may detect damage not visible immediately after the injury.
- MRI is more sensitive than CT scans in demonstrating certain types of injury.
- Single Photon Emission Computed Tomography scan is a relatively new imaging method that is still being studied in people with head injuries. It may be better than CT scans or MRIs in detecting functional problems in the brain for some types of dementia or other brain disorders. SPECT is available only at some large medical centres.
- Electroencephalogram measures the electrical activity of the brain. It may be used to diagnose seizures or abnormally slow rates of brain activity.
What Causes Dementia In Head Injury Cases
The following are the most common causes of head injury in civilians:
- Motor vehicle accidents
- Assault or gunshot wound
- Sports, such as boxing , or other recreational activity
The use of alcohol or other substances is a factor in about half of these injuries.
Certain groups are more likely than others to sustain a head injury.
- In children, bicycle accidents are a significant cause of head injury.
- Most head injuries in infants reflect child abuse. A common name for this is shaken baby syndrome.
- Elderly persons are especially likely to injure themselves by falling.
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What Is The Link Between Brain Injury And Dementia
Dementia is an umbrella term for a collection of cognitive and communicative deficits. Memory loss, executive functioning deficits, communication impairments and challenging behavior are the hallmarks of a dementia diagnosis. This can be extremely difficult for the person and their family, who have already endured a brain injury.
The link between brain injury and dementia is clear. Dementia affects 50 million people worldwide, and studies show that people who sustain an injury to the brain are twice as likely to develop dementia post-injury.
Are There Home Remedies For Stroke
A person with vascular dementia should be under medical care. There are steps you can take, however, to reduce your risk of further vascular damage or stroke. The most important thing you can do is adopt healthy habits. You should maintain a healthy weight, eat a balanced and healthy diet, exercise regularly, and not smoke.
You must develop a realistic attitude toward your limitations. You may require assistance with some everyday tasks, such as managing your finances. You may have to give up some of your independence . Your safety, and the safety of others, depends on it.
Many people with vascular dementia are eventually unable to live independently and care for themselves. Often, family members become responsible for their care. Your health care provider can discuss with you and your family how you should plan for future care.
Tips for the caregiver
Caregiving is best when it is structured, respectful, and friendly. This type of caregiving is the best way to approach the person’s behavioral problems.
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What Facts Should I Know About Dementia In Head Injury
A head injury occurs when an outside force hits the head hard enough to cause the brain to move violently within the skull. This force can cause shaking, twisting, bruising , or sudden change in the movement of the brain .
- In some cases, the skull can break. If the skull is not broken, the injury is a closed head injury. If the skull is broken, the injury is an open head injury.
- In either case, the violent jarring of the brain damages brain tissue and tears nerves, blood vessels, and membranes.
- The severity of this damage depends on the location and force of the blow to the head.
Damaged brain tissue does not work normally.
- The brain has many different functions in the body, and any of them can be disrupted by this damage.
- Not all brain damage is permanent. Like all body organs, the brain can heal to a certain extent.
- Even this healing may not bring the brains function back to what it was before the injury.
Even a relatively mild head injury can cause prolonged or permanent declines in cognition. Head injury can also cause changes in emotions or behavior.
- Together, these changes are known as dementia.
- The nature of dementia in head-injured persons varies greatly by type and location of head injury and the persons characteristics before the head injury.
After a head injury, a person may have symptoms such as changes in personality, emotional problems, and difficulty making decisions or solving problems.
How Do You Prevent Dementia In Head Injury Cases
Head injury and its resulting complications, such as dementia, are highly preventable.
- Use of protective gear in contact sports, seat belts and bicycle and motorcycle helmets aboard conveyances, and hard hats and safety equipment at work prevent head injuries.
- For elderly persons, altering the surroundings to lower the risk of falls is important.
- Protecting children from child abuse helps prevent head injuries.
A person who has experienced a head injury is at risk for further head injuries. Lower the danger by being aware of risk factors.
- Avoiding substance abuse makes further injury less likely.
- Some patients with head injury have suicidal thoughts. These people require immediate medical attention. In many cases, suicide can be prevented with treatment of depression, counseling, and other therapy.
- Athletes should not return to play until they have been cleared by their health care provider.
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Whats The Difference Between Vascular Dementia And Alzheimers Disease
Although both are conditions under the larger umbrella of dementia, there are important differences. First, the cause of these dementias is different. Alzheimers disease is caused by a buildup of amyloid plaques and tau proteins between and inside nerve cells in your brain. This causes brain cells to die. Vascular dementia is caused by a lack of blood flow to areas of your brain, which results in brain tissue damage and death.
Another difference is the rate at which symptoms develop. Alzheimers symptoms usually develop at a slow, steady pace. Vascular dementias course is usually more like a staircase with sudden periods of decline and then by more sudden periods of decline, as additional strokes happen.
Also, some symptoms appear at different points in time in these diseases. Memory loss is an early symptom of Alzheimers disease a person with early Alzheimers will often ask the same question within minutes without realizing it, fail to recognize a family member or may seem to forget the meanings of common words. This isnt necessarily an early sign of vascular dementia unless that area of the brain is damaged early in the course of the disease. Instead, vascular dementia tends to affect executive functions first abilities like reasoning, judgment and problem-solving. Memory problems often appear as forgetfulness although, a person will often remember the thing they forgot when given more time to think about it or when given some hints.
Why Might A Brain Injury Lead To Dementia
Why certain injury to the brain can cause dementia in older age is not always clear, though there are many working theories.
Alzheimers disease is the most common form of dementia, estimated to affect 5.5 million people in America today. AD accounts for between 60-80% of all cases of dementia, and is caused by an abnormal buildup of proteins in the brain, which interrupt and disrupt the messages being sent within the brain itself.
Some research shows that injury to the blood-brain-barrier, a membrane that selectively filters nutrients from the bloodstream into the brain, has a strong link to subsequent development of Alzheimers. The blood brain barrier can be damaged by hypoxia- oxygen deprivation that may be caused by a blockage- or by a traumatic brain injury.
Vascular dementia , the second most commonly experienced dementia, is a step-wise decline in function as a result of several strokes. Strokes often cause temporary or long-lasting damage to the tissues in the brain, and the amount of recovery to these tissues may vary. When multiple strokes or brain injuries occur, the brain is not be able to heal fully, in time leading to VD.
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How Is Vascular Dementia Linked To Stroke
When you have a stroke, the blood supply to part of your brain is cut off, killing brain cells. The damage from a stroke can cause problems with memory and thinking. For many people, these problems improve over time. If the problems dont improve or get worse this may be a sign of vascular dementia.
Vascular dementia can also be caused by a series of small strokes. These result in lots of small areas of damage in your brain. Often, these strokes can be so small that you don’t know you are having them. These are known as silent strokes.
Sometimes symptoms of vascular dementia can be confused with the effects of stroke. Both stroke and vascular dementia can cause problems with memory, thinking and mood. Strokes happen suddenly while the symptoms of vascular dementia often get worse over time. The difference is that vascular dementia gets worse over time. If youre unsure, go to see your GP.
Cognitive Remediation After Intracerebral Hemorrhage
Many patients recovering from an intracerebral hemorrhage experience some degree of emotional difficulties and/or cognitive changes. A therapy called cognitive remediation also known as cognitive rehab or cognitive rehabilitation can help.
Cognitive dysfunction is one possible complication of any brain disorder. Brain bleeds and their treatment may cause physical changes to brain tissue and can lead to diffuse cognitive deficits, including problems with attention, memory, executive functioning, and information processing.
Executive functioning problems include difficulty with executing everyday actions, such as carrying out a sequence of actions, planning a task, beginning a task, knowing when one has completed a task, or even becoming lost while in the middle of a task. Executive functioning problems are highly related to problems carrying out everyday activities.
A hemorrhage also affects mood and emotions, and this is not simply a reaction to a life-threatening event. The area of the brain in which a hemorrhage occurs determines what functions are affected, which could be speech, motor control, cognition, or even emotions. For example, damage to the left temporal lobe is associated with low mood, but damage on the right side can produce manic reactions. Damage in the frontal lobe will often modify emotional processing and behavior.
What is cognitive remediation/cognitive rehabilitation?
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How Long Can Person With Vascular Dementia Care For Themselves
A person with vascular dementia will need help with at least some aspects of daily function, such as managing medications, paying bills or preparing food. You or your family member with vascular dementia may be able to do many things for themselves although, it may not be safe for them to live alone, depending on what abilities are affected. For some people with vascular dementia, more specialized care may be required from facilities that care specifically for people with dementia.
What Is The Treatment For Dementia In Head Injury Cases
Head injuries often bring an abrupt coping crisis. The sudden adverse changes that go with a head injury inevitability cause many emotions. Anxiety is a common response, and the person may become demoralized or depressed. Damage to the brain may impair the persons ability to cope at a time when the need to adapt is greatest. Persons with head injuries typically are more distressed and have more difficulty coping with their injury than persons who have other types of injuries.
Usually, a particular family member assumes most of the responsibility for the injured persons care. Ideally, more than one family member should be closely involved in caregiving. This helps family members share the burdens of providing care and helps the primary caregiver keep from becoming isolated or overwhelmed. Caregivers should be included in all significant interactions with health care professionals.
Caregivers must encourage and expect the injured person to be as independent and productive as possible. At the same time, caregivers need to be patient and tolerant. They should accept that the person may have real limitations and that these will likely worsen if the person is tired, ill, or stressed. Emphasizing what the person can still do, rather than what seems to be lost, is helpful.
With head injuries, the greatest improvement is expected in the first 6 months, but delayed improvement is possible as long as 5 years after injury.
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What Are Tumors And Subdural Hematomas
Brain tumors can arise from any number of conditions or situations, including any tumor inside the cranium, or in the central spinal canal. They can be cancerous or non-cancerous in nature. Any kind of brain tumor can pose a serious risk to an individual’s health and life, due to its invasive nature.
A subdural hematoma is a clot of blood just beneath the outer covering of the brain. Usually occurring in patients over the age of 60, these clots typically form in conjunction with an atrophy of the brain.
Minor head trauma can damage the brain surface’s blood vessels, and slowly accumulate blood over several days. Most often, SDHs become very large before they are noticed because of the lack of symptoms in the early stages.
Is Vascular Dementia Hereditary
Vascular dementia isnt hereditary, but the disorders that cause vascular dementia can be.
There are two rare forms of vascular dementia that are caused by mutations in certain genes. Both mainly affect the small blood vessels in the white matter of your brain. They are:
- CADASIL: Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy.
- CARASIL: Cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy.
CADASIL requires only one parent to have the condition for your child to inherit it CARASIL needs both parents to be carriers of the condition for your child to inherit it and show symptoms.
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Can You Treat Dementia After Stroke
With vascular dementia, there is hope for improvement through cognitive rehabilitation, which is possible thanks to neuroplasticity.
Neuroplasticity is the process the brain uses to rewire itself and form new connections, as well as strengthen existing connections. When part of the brain sustains damage after a stroke, neuroplasticity allows healthy areas of the brain to take over. However, it does not occur without your help.
In order for neuroplasticity to work, the brain needs to see a demand for a function. For example, the brain wont improve at the skill of riding a bike unless you attempt to ride a bike in the first place, because this shows a demand for that function. To apply this concept to cognitive health, this is where cognitive rehabilitation exercises come into play.
Cognitive exercises draw upon desired thinking skills, such as memory and attention. When the brain sees a demand for these skills, it will attempt to adapt. For example, by practicing memory exercises, the brain perceives the demand for the function of memory, and it responds by creating and strengthening neural pathways responsible for memory.
When To Seek Medical Care For Dementia
Any of the symptoms and signs described in the symptoms section warrants a visit to the personâs health care provider. This is true regardless of whether the person has a known head injury. Be sure the health care provider knows about any falls or accidents that could have involved even a mild head injury.
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Warfarin Levels & Dementia: Second Opinion
The new findings definitely suggest that keeping warfarin within the ideal range provides dementia protection as well as stroke protection, says Luigi Di Biase, MD, PhD, senior researcher at the Texas Cardiac Arrhythmia Institute, St. David’s Medical Center, Austin. He reviewed the findings.
“It makes absolute sense,” he says. However, he concedes, it can be difficult for patients with atrial fibrillation to stay in that optimal range. This is because warfarin can interact with other drugs. And certain foods and drink can affect how well warfarin works.
Treatments For Dementia From Brain Conditions
Treatments for brain tumors vary depending on whether they are malignant or benign. Most treatments include some kind of reductive surgery, and cancerous conditions can be treated with radiation therapy or chemotherapy.
After the brain injury, the success of treatment varies. The typical treatment, once detected, is to drill a small hole in the outer layer of the skull and drain the mass of collected blood through a catheter. Approximately 80 to 90 percent of all patients treated this way eventually recover significant portions of brain functionality.
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How Does A Brain Bleed Affect A Patient
As mentioned previously, in the worst cases of brain bleeding, the result could be death. This is of course dependent on the severity of the bleed. Minor bleeding may not cause any significant or visible health challenges, and may not affect the lifespan of the individual. Where the bleed is located within the brain, as well as when it is detected and subsequently treated, may be determining factors of survival.