Heavy alcohol use linked to brain bleed in later life

People who drink heavily are more likely to suffer severe brain bleeds at a younger age, with larger haemorrhages occurring about a decade earlier than in non-drinkers, new research has revealed.

Patients who consumed three or more alcoholic drinks a day experienced brain bleeds at an average age of 64, compared with 75 for non-drinkers, and had haemorrhages about 70 per cent larger.

The findings come from an analysis of 1,600 patients admitted to Massachusetts General Hospital between 2003 and 2019 with non-traumatic brain bleeds.

Brain bleeds, also known as intracerebral haemorrhages or haemorrhagic strokes, occur when a blood vessel inside the brain bursts.

Researchers from Mass General Brigham used CT scans to assess the size and location of the bleeds and MRI scans to check for small blood vessel damage.

Around 7 per cent of patients reported drinking three or more alcoholic drinks each day.

These heavy drinkers were twice as likely to have bleeds deep within the brain or ones that extended into the ventricles — the fluid-filled spaces that hold cerebrospinal fluid.

“The brain bleed is one of the most lethal and disabling conditions known to human beings,” said corresponding author Dr Edip Gurol, clinician investigator in the Mass General Brigham department of neurology.

“They come on suddenly, cause severe damage and often leave patients with life-changing disabilities. It’s one of the most difficult conditions to recover from.”

Up to 50 per cent of people with brain bleeds die, 30 per cent are left severely disabled, and only 20 per cent are able to care for themselves independently a year later.

Heavy drinkers had lower platelet counts — the cell fragments that help blood clot — and higher blood pressure on hospital admission. They also showed more signs of small vessel disease, which is linked to dementia, memory loss and mobility problems.

Even moderate drinking of around two drinks per day was significantly associated with a younger age of onset.

Researchers believe heavy alcohol use raises blood pressure and damages small blood vessels in the brain, making them more likely to leak or burst.

Lower platelet levels further reduce the body’s ability to stop bleeding, increasing the risk of severe haemorrhage.

“We now know that heavy drinking leads to larger, earlier brain bleeds,” said Dr Gurol.

“Minimising or stopping alcohol use is an important step to lower that risk. Even for people at relatively low risk, limiting alcohol consumption to no more than three drinks per week may help protect against all types of stroke and preserve both brain and cardiovascular health.”

The researchers noted several limitations, including self-reported alcohol use, the small number of heavy drinkers, single-hospital data and a predominantly white patient group.

As the study captured only one point in time, it could not show cause and effect.

Future studies in larger and more diverse populations are needed to explore how different levels of alcohol consumption affect small vessel disease, brain ageing and the risk of blockage-type stroke.