Regular exercise may reduce risk of brain haemorrhage

Regular physical activity can reduce bleeding in intracerebral hemorrhage.


A new study found that people who reported regular physical activity had smaller intracerebral hemorrhages than those who reported being inactive. The study analyzed data on 686 people treated for intracerebral hemorrhage at Sahlgrenska University Hospital in Gothenburg from 2014 to 2019.

Physically active was defined as engaging in at least light physical activity, such as walking, cycling, swimming, gardening, or dancing, for at least four hours weekly.

Regular physical activity has been found to reduce bleeding volume by 50% in individuals with intracerebral hemorrhage, according to a study conducted by Adam Viktorisson, a Ph.D. student in clinical neuroscience at Sahlgrenska Academy. 

This finding, not previously demonstrated in humans, supports earlier observations from animal studies. Patients suspected of intracerebral hemorrhage typically undergo a brain CT scan upon hospital arrival, with neurosurgery being necessary in severe cases. However, most cases are managed through non-surgical methods and medication. Intracerebral hemorrhage is the most dangerous form of stroke, with the risk of severe consequences increasing with the extent of bleeding, potentially leading to fatal outcomes.

“In cases of major intracerebral hemorrhages, there is a risk of increased pressure within the skull that can potentially lead to fatal outcomes.” said Thomas Skoglund, associate professor of neurosurgery at the University of Gothenburg, a neurosurgeon at the University Hospital, and one of the study’s co-authors.

The study’s findings revealed that regular physical activity was associated with reduced bleeding volume in both deep and surface regions of the brain, regardless of their specific locations.

This opens up avenues for future research on the relationship between physical activity and intracerebral hemorrhages. Katharina Stibrant Sunnerhagen, a professor of rehabilitation medicine at the University of Gothenburg, oversees the study.

The study included 686 patients with primary intracerebral hemorrhage (ICH), a type of stroke that occurs when a blood vessel in the brain ruptures. The patients were all admitted to three hospitals in Sweden between 2014 and 2019. The researchers defined physical activity (PA) as engaging in at least 4 hours of light PA per week. Light PA includes activities such as walking, cycling, and swimming.

The researchers used brain imaging to measure the volume of the hematoma, which is the amount of blood leaked into the brain. They also assessed the severity of the stroke using the National Institutes of Health Stroke Scale (NIHSS) and the modified Rankin Scale (mRS).

The researchers found that patients who were physically active before their stroke had smaller hematoma volumes than patients who were not physically active. They also found that patients who were physically active were more likely to have a mild stroke (NIHSS score of 0-4) and to survive for 90 days (mRS score of 0-3).

The researchers also found that the relationship between PA and stroke severity was mediated by hematoma volume. This means that the smaller hematoma volumes in physically active patients were partly responsible for their better outcomes.

The researchers concluded that physical activity is associated with smaller hematoma volumes and better outcomes after intracerebral hemorrhage. They suggest that people at risk of ICH should be encouraged to be physically active.

Here are some of the study’s limitations:

• The study was observational, meaning it cannot prove that physical activity caused better outcomes.

• The study only looked at people who had already had an ICH. It is not clear whether physical activity would help to prevent ICH in the first place.

• The study did not examine the type of physical activity people did. It is possible that some types of physical activity are more beneficial than others.

Despite these limitations, the study provides evidence that physical activity may benefit brain health. More research is needed to confirm these findings and to determine the best type and amount of physical activity for preventing and treating intracerebral hemorrhage.

Journal Reference:

  1. Adam Viktorisson, Dongni Buvarp, Anna Danielsson etal. Prestroke physical activity is associated with admission hematoma volume and the clinical outcome of intracerebral hemorrhage. Stroke and Vascular Neurology. DOI:10.1136/svn-2023-002316
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