Cerebral hemorrhage is responsible for 10-15% of all strokes. High blood pressure and vascular disease called cerebral amyloid angiopathy are the main causes of cerebral hemorrhage. Untreated hypertension is the most important risk factor for cerebral hemorrhage . The follow-up of patients who survived cerebral hemorrhage and the treatment of blood pressure disease are necessary to reduce the risk of re-bleeding. As the follow-up period of the patients increases, the recurrence rate of cerebral hemorrhage also increases. The probability of recurrence of cerebral hemorrhage is 5-10% (2-4% per year). Rebleeding can occur as early as one month after the first or as late as 10 years later, with an average duration of 3 years. The results of the second cerebral hemorrhage are generally more severe than the first (1).
Blood pressure control is important
Bleeding in the brain have undergone if patients do not take their blood pressure under control in terms of spending could be repeated at a higher risk of brain hemorrhage. In a study in which approximately 1100 patients who had a stroke due to cerebral hemorrhage were followed for 3 years, it was observed that 146 recurrent cerebral hemorrhages developed. The risk of second-time bleeding was found to be higher in people with poor blood pressure control. In fact, the higher the blood pressure, the higher the risk of recurrence (2).
Can a patient who has had a brain hemorrhage use blood thinners?
Antiplatelet drugs such as aspirin are frequently used in cardiovascular diseases and their beneficial effects are known in strokes due to clot formation and vascular occlusion. Antiplatelet therapy can be given again in people who have had a previous cerebral hemorrhage due to the benefits mentioned. So, do antiplatelet drugs increase the risk of cerebral hemorrhage? According to the results of scientific research, this treatment does not cause a significant increase in the risk of recurrence of cerebral hemorrhage. Of course, the resumption of antiplatelet therapy in these patients is decided by the physician by weighing the risks of profit and loss specific to the patient (3).
Brain hemorrhages caused by cerebral amyloid angiopathy have a higher risk of recurrence than cerebral hemorrhages caused by vascular calcification (atherosclerosis). In a study published in 2018, scientists proposed a model that predicts whether brain hemorrhage will recur or not, by using brain tomography images and genetic tests for the APOE gene (4).
Cerebral micro-hemorrhages are small hemorrhages in the brain, which are noticed by the widespread use of MRI scans and observed in normal people. They do not cause any problems. However, according to an article published in 2016, cerebral micro-hemorrhage in people who have had a vascular occlusion (ischemic) stroke poses a higher risk for a second stroke due to vascular occlusion or cerebral hemorrhage (5).