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Intracerebral Hemorrhage

Alternate Names

  • intraparenchymal brain hemorrhage
  • intracranial hemorrhage
  • Brain hemorrhage

Definition

Intracerebral hemorrhage is a term for bleeding into the brain.

What is going on in the body?

When blood leaks into the brain for any reason, it can have significant consequences. The brain controls many functions in the body. An intracerebral hemorrhage can damage the cells that control these functions, resulting in temporary or permanent disability or death.

Risks

What are the causes and risks of the condition?

The possible causes of intracerebral hemorrhage include:
  • high blood pressure
  • weakened or abnormal blood vessels, such as a cerebral aneurysm
  • abuse of drugs, such as cocaine
  • head injury
  • brain tumor
  • abnormal bleeding tendencies
  • treatment with medications that thin the blood, such as anticoagulants or thrombolytics

Prevention

What can be done to prevent the condition?

Proper control of high blood pressure with medications can help prevent some intracerebral hemorrhages. Avoiding illicit drugs such as cocaine will decrease the risk.of this condition. A person who takes anticoagulant medications for long periods of time must be monitored. Many cases cannot be prevented.

Diagnosed

How is the condition diagnosed?

The history and physical exam, including a neurological exam, are the first steps in diagnosis of intracerebral hemorrhage.
Tests may be done to show the location and amount of the blood in the brain. These tests may include:
  • cranial CT scan
  • cranial MRI
  • cerebral angiography, in which a contrast agent is injected into the blood vessels of the brain
These tests can show the location and amount of the blood in the brain.

Long Term Effects

What are the long-term effects of the condition?

Intracerebral hemorrhage can cause permanent neurologic damage. A person may become unable to perform self-care activities, walk, or talk normally.

Other Risks

What are the risks to others?

An intracerebral hemorrhage is not contagious, and poses no risks to others.

Treatments

What are the treatments for the condition?

Intracerebral hemorrhage is a severe condition requiring prompt medical attention. Treatment goals include lifesaving interventions, supportive measures, and control of symptoms. Treatment depends on the location, extent, and cause of the bleeding. Often, treatment cannot reverse the damage that has been done.
A craniotomy (surgical cut through the skull into the brain) is sometimes done to remove blood, fix abnormal blood vessels, or to take out a tumor. Medications may be used to reduce swelling, prevent seizures, lower blood pressure, and/or control pain.

Side Effects

What are the side effects of the treatments?

Surgery can be complicated by further bleeding, infection, an allergic reaction to the anesthetic, or even death. Side effects of medications vary, but may include allergic reactions.

After Treatment

What happens after treatment for the condition?

A person with an intracerebral hemorrhage may recover completely, have permanent neurologic injury, or even die. The care after treatment depends on the person's needs and condition.

Monitor

How is the condition monitored?

After initial diagnosis and treatment of an intracerebral hemorrhage, measures to correct or monitor the underlying cause of the bleeding may be taken. For example, a person's high blood pressure may be watched closely and treated aggressively to prevent a second bleeding episode.

Sources

Harrison's Principles of Internal Medicine, 1998, Fauci et al.

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