Bombay Jayashri health update: What is an aneurysm, and causes and treatment of brain haemorhage

Bombay Jayashri was honoured with Padma Shri, India's fourth highest civilian award, in 2021. (File picture; photo by Sudha/.carnaticdarbar.com)

Bombay Jayashri, renowned Carnatic vocalist and singer in multiple Indian film industries, was found unconscious in her London hotel today. She was rushed to the hospital where a brain hemorrhage was detected. According to the latest reports, her doctors there are trying to stabilize her vitals and are closely monitoring her condition to prepare to perform a keyhole surgery to treat the aneurysm (ballooning of a blood vessel wall) in her brain.

What is a brain haemorrhage?

Brain haemorrhage is a serious medical condition in which bleeding occurs inside or around the brain. As a result, some parts of the brain do not get an adequate supply of oxygen. As time elapses, brain cells start dying. The death of brain cells due to bleeding is known as haemorrhagic stroke.

What are the symptoms of a brain haemorrhage?

As per sources, Bombay Jayashri complained of severe pain in her neck a day before she went into a coma and did not show up for breakfast and lunch the next day. After several attempts of contacting her further, they couldn’t get any response from her room. The door was broken open and she was found in an unconscious state in her room.

But is neck pain the only symptom? No. There are different symptoms, and a person can suffer from any one or more of them, such as:

1.    Severe headache

2.    Stiffness in the neck

3.    Feeling sick (nausea)

4.    High sensitivity to light

5.    Blurring of vision or double vision

6.    Slurring of speech or numbness/weakness in either half of the body

7.    Convulsions or seizures or fits

8.    Losing consciousness

Causes of brain haemorrhage

Brain haemorrhage is most commonly seen in people between 45 and 70 years of age. It is of two types – haemorrhage inside the brain or on the surface of the brain:

Haemorrhage inside the brain (Intracerebral haemorrhage)

1.    Small blood vessels inside the brain can get damaged due to high blood pressure or the deposition of a protein called beta-amyloid in the blood vessels. When these blood vessels get damaged, blood starts to leak into the brain tissues, which can also compress the brain stem (a vital part of the brain from which all the nerves emerge).

2.    Abnormally large or small blood vessels can affect the blood flow to different parts of the brain. The smaller blood vessels are often tangled together and they supply oxygen to different parts of the brain. When blood passes through with pressure in any of the abnormally weakened vessels, it can cause bleeding. Similarly, enlarged blood vessels can be filled with blood, often weakening the vessel walls, resulting in a haemorrhage.

An aneurysm or a bulge in the wall of an artery can happen anywhere in the body, but it is particularly dangerous when it occurs in the brain. An aneurysm leads to weakening of the affected blood vessel, which may then burst, causing a brain haemorrhage (a bleed in the brain). It is often difficult to diagnose a brain aneurysm as the symptoms typically develop when the condition is quite advanced. People with chronic ailments like high blood pressure or diabetes must manage these conditions with medication and a healthy lifestyle, to reduce their risk of developing an aneurysm.

Haemorrhage of the brain surface (Subarachnoid haemorrhage)

The brain is covered by two protective layers which have blood vessels to supply oxygen and other important nutrients to them. When one of these vessels gets filled with blood, it balloons out (called an aneurysm) and causes blood leakage on the brain's surface.

How is brain haemorrhage treated?

The treatment approach varies for intracerebral and subarachnoid haemorrhage, but the end goal is to stop the bleeding, repair the damage and prevent the possibility of a future haemorrhage. Multiple imaging modalities like CT scan or MRI are done to locate and examine the haemorrhage. In general, a brain haemorrhage is treated by:

1.    Stabilizing the condition: The brain is the primary organ that controls all the vital organs of the body. It is, therefore, crucial to ensure that the airway, breathing, blood circulation, disability due to haemorrhage and exposure of the affected area to further harm are monitored and managed effectively to reduce threat to life.

2.    Medication: Some medicines are prescribed to prevent the occurrence of a secondary haemorrhage and brain damage. Other than that, painkillers are also given for symptomatic relief from headache or neck pain, and anticonvulsants for preventing seizures and antiemetics for helping with nausea and vomiting.

3.    Surgery: Surgery depends on the location and size of the rupture. The purpose here is to shut a ballooned vessel and prevent blood from entering it and repair the damaged blood vessel. It is either done by coiling (filling the aneurysm with platinum coils) or clipping (using a metal clip to shut it off from the base). For haemorrhages inside the brain, the surgery involves opening some part of the skull to access the damaged vessel, removing the inflammatory fluids to prevent swelling and repairing the blood vessel. Surgery is considered risky and unlikely to improve the condition when the brainstem is extensively affected.

Brain haemorrhage is an emergency condition and often an unfortunate one. A person’s ability to recover from a brain haemorrhage often depends upon how soon they receive the necessary treatment.