Bleeding inside the skull, or a large stroke that makes the brain swell, can raise pressure quickly and put life at risk. Some patients are managed in intensive care with medicines; others need an operation to remove blood, relieve pressure, or treat the cause of the bleed.
Who it may help
- A sudden severe headache with vomiting
- Sudden weakness or numbness on one side of the body
- Slurred speech or difficulty understanding
- Seizure or loss of consciousness
- Unequal pupils or abnormal eye movements
- A CT or MRI showing a bleed or a large area of stroke with swelling
Conditions treated
- Intracerebral haemorrhage
- Subarachnoid haemorrhage
- Intraventricular haemorrhage
- Large (malignant) middle cerebral artery stroke
- Bleeding caused by an AVM or other vessel abnormality
- Traumatic brain bleeds
Emergency treatments
- Craniotomy and clot removal A window in the skull is opened and the blood clot is removed to relieve pressure.
- Decompressive craniectomy Part of the skull is temporarily removed to give a swollen brain room.
- External ventricular drain (EVD) A thin drain placed into the brain’s fluid spaces when blood blocks fluid flow.
- Treating the cause Clipping or coiling a ruptured aneurysm, or treating an AVM.
- Intensive-care management Close control of blood pressure, seizures and brain pressure, for smaller or inoperable bleeds.
Before the procedure
- An urgent CT scan, often with CT angiography
- Blood tests and an anaesthesia review
- A rapid, honest explanation to the family of the risks and the aim of surgery
- Admission to intensive care with blood pressure and seizure control
Recovery: what to expect
- Intensive-care monitoring for the first 2 to 3 days.
- A hospital stay of about 7 to 12 days, depending on severity.
- Continuous checks on brain pressure and consciousness.
- Rehabilitation starts early: physiotherapy, speech therapy and help with feeding.
- Progress reviewed at about 1, 3 and 6 months.
- The family is taught about feeding, movement and home care.
These are typical timings. Your own plan depends on your condition, your general health and the operation chosen, and Dr. Chakraborty will go through it with you.
Risks to know about
Every operation carries risk. The ones most relevant here are:
- Re-bleeding, infection or swelling
- Lasting weakness, speech or thinking problems
- Seizures
- Complications of a long period in bed, such as chest infection or clots in the legs
- In severe cases, the outcome may be poor even with prompt treatment
Your own risks depend on your health and your scans, and are explained in detail before you decide on anything.
Common questions
Is surgery always needed?
No. Small, stable bleeds can be treated in intensive care. Large or life-threatening bleeds often need an operation.
How quickly should someone with stroke symptoms be brought in?
At once. Stroke is time-critical, and early treatment gives the best chance of recovery.
What is recovery like after a major stroke?
It varies widely. Some people recover well and others need long-term rehabilitation.
Is surgery needed for a stroke caused by a blocked artery?
Only in severe cases with brain swelling. Others may be treated with clot-dissolving medicines, clot retrieval or stenting.
This page is general information to help you prepare for a consultation. It is not medical advice and does not replace an examination. Every plan is made for the individual patient.