Petechial hemorrhage is also known as capillary hemorrhage, as it occurs when capillaries burst. In general, hemorrhage is the escape of blood from a ruptured vessel. Apart from the visible signs of blood loss from an open wound, a hemorrhage can be identified by signs such as cold and clammy skin, increased pulse rate, rapid and shallow respirations and a drop in blood pressure.
Petechial hemorrhage is a subcutaneous hemorrhage. It is a form of mild hemorrhage that causes distinctive markings called petechiae. A petechial hemorrhage in the brain occurs as result of a brain contusion, which is a form of traumatic brain injury that leads to the bruising of the brain tissues. It is associated with multiple micro-hemorrhages wherein small blood vessels leak into the brain. In the case of petechial hemorrhage in the brain, there are numerous contusions in the capillaries that supply blood to the grey matter under the cortex. This is known as multiple petechial hemorrhage. The contusions often occur at the junction between the grey and white matter and in the upper brain stem. It also occurs in the basal ganglia, thalamus, and in areas surrounding the third ventricle.
The causes of petechial hemorrhages are injury to the brain and trauma. This type of multiple petechial hemorrhage is not often visible in imaging techniques such as CT and MRI scans. It is visible in case the injury is very severe, and it generally shows up only after few days. It is difficult to diagnose such kind of hemorrhages if the patient is comatose. Positron emission tomography is conducted to get better results and a more definite diagnosis.
The symptoms of petechial hemorrhage include difficulty in breathing, sight, speech, and hearing, and an inability to manage emotions and thought processes. The signs largely depend on the contusion’s location in the brain. The other symptoms include reduced task efficiency and concentration, a reduced capacity in word finding and difficulty in mental organization. The physical symptoms include headaches, disturbances in sleep, fatigue, lack of energy, dizziness, ringing in the ears, blurred vision and photophobia. The condition can also result in behavioral changes. These include irritability, anxiety, angry outbursts, mood swings, depression, and bad social judgment. The signs and symptoms are known as post-concussion syndrome (PCS).
PCS is often to be presumed only when the complaints follow a head injury. However, this method is not quite reliable as people are not always able to identify a difference between pre and post injury behavior. Therefore, to confirm any brain injury, neuro-psychological tests are necessary.
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