Definition
An intracerebral hemorrhage is bleeding in the brain caused by the rupture of a blood vessel within the head. See also hemorrhagic stroke .
Symptoms
- Headache
- May occur when lying flat
- May awaken patient from sleep
- May increase with change in position
- May increase with bending, straining, and coughing
- Nausea, vomiting
- Change in alertness (level of consciousness)
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Symptoms
- Headache
- May occur when lying flat
- May awaken patient from sleep
- May increase with change in position
- May increase with bending, straining, and coughing
- Nausea, vomiting
- Change in alertness (level of consciousness)
- Vision changes
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Causes
Internal bleeding can occur in any part of the brain. Blood may accumulate in the brain tissues itself, or in the space between the brain and the membranes covering it. The bleeding may be isolated to part of one hemisphere ( lobar intracerebral hemorrhage ) or it may occur in other brain structures, such as the thalamus, basal ganglia, pons, or cerebellum ( deep intracerebral hemorrhage ).
An intracerebral hemorrhage can be caused by a traumatic brain injury or abnormalities of the blood vessels ( aneurysm or angioma). When it is not caused by one of these conditions, it is most commonly associated with high blood pressure ( hypertensive intracerebral hemorrhage ). In some cases, no cause can be found.
Blood irritates the brain tissues, causing swelling (cerebral edema). It can collect into a mass called a hematoma. Either swelling or a hematoma will increase pressure ...
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Treatment
An intracerebral hemorrhage is a severe condition requiring prompt medical attention. It may develop quickly into a life-threatening situation.
Treatment depends on the location, cause, and extent of the hemorrhage.
Surgery may be needed, especially if there is bleeding in the cerebellum. Surgery may also be done to repair or remove structures causing the bleed (such as a cerebral aneurysm or arteriovenous malformation ).
Medicines used may include painkillers, corticosteroids or diuretics to reduce swelling, and anticonvulsants to control seizures. Blood, blood products, and intravenous fluids may be needed to make up for loss of blood and fluids. Other treatments may be recommended, depending on the condition of the person and the symptoms that develop.
Other Names
Intracranial hemorrhage; Hemorrhage - intracerebral; Hypertensive hemorrhage
Outlook (Prognosis)
How well a patient does depends on the size of the hematoma and the amount of swelling.
Recovery may occur completely, or there may be some permanent loss of brain function. Death is possible, and may quickly occur despite prompt medical treatment.
Medications, surgery, or other treatments may have severe side effects.
Prevention
Treatment and control of underlying disorders may reduce the risk of developing intracerebral hemorrhage. High blood pressure should be treated. Do not stop taking medications unless told to do so by your doctor.
Conditions such as an aneurysm can often be treated before they cause bleeding in the brain.
Exams and Tests
A neurological exam may suggest increased intracranial pressure or decreased brain functions. The person's specific symptoms can help tell which part of the brain is affected.
An eye exam may show swelling of the optic nerve from increased pressure in the brain. There may be changes in eye movement, abnormal reflexes, decreased vision, loss of movement or coordination, or inability to feel sensations properly.
Tests may include:
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