Intraparenchymal hematoma
| Intracerebral hemorrhage | |
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| Synonyms | Cerebral haemorrhage, cerebral hemorrhage, intra-axial hemorrhage, cerebral hematoma, cerebral bleed |
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| CT scan of a spontaneous intracerebral bleed, leaking into the lateral ventricles | |
| Specialty | Neurosurgery |
| Symptoms | Headache, one-sided weakness, vomiting, seizures, decreased level of consciousness, neck stiffness, fever |
| Causes | Brain trauma, aneurysms, arteriovenous malformations, brain tumors |
| Risk factors | High blood pressure, amyloidosis, alcoholism, low cholesterol, blood thinners, cocaine |
| Diagnostic method | CT scan |
| Similar conditions | Ischemic stroke |
| Treatment | Blood pressure control, surgery, ventricular drain |
| Prognosis | 20% good outcome |
| Frequency | 2.5 per 10,000 people a year |
| Deaths | 44% die within one month |
| Classification |
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Intracerebral hemorrhage (ICH), also known as cerebral bleed, is a type of intracranial bleed that occurs within the brain tissue or ventricles. Symptoms can include headache, one-sided weakness, vomiting, seizures, decreased level of consciousness, and neck stiffness. Often symptoms get worse over time.Fever is also common. In many cases bleeding is present in both the brain tissue and the ventricles.
Causes include brain trauma, aneurysms, arteriovenous malformations, and brain tumors. The largest risk factors for spontaneous bleeding are high blood pressure and amyloidosis. Other risk factors include alcoholism, low cholesterol, blood thinners, and cocaine use. Diagnosis is typically by CT scan. Other conditions that may present similarly include ischemic stroke.
Treatment should typically be carried out in an intensive care unit. Guidelines recommended decreasing the blood pressure to a systolic of less than 140 mmHg. Blood thinners should be reversed if possible and blood sugar kept in the normal range. Surgery to place a ventricular drain may be used to treat hydrocephalus but corticosteroids should not be used. Surgery to remove the blood is useful in certain cases.
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