Intracerebral Hemorrhage: Symptoms and Treatment

Overview

Intracerebral hemorrhage (ICH) is the inner bleeding to the surface, or in deep areas of your brains. When too much blood build up in your brain, they will put pressure on your brain and interfere with its oxygen supply, leading to more serious symptoms. Hypertension is the most common cause of Intracerebral hemorrhage.

In the US, 0.012% to 0.015% of the total population are diagnosed with intracerebral hemorrhage per year. In every 100,000 elderly individuals with ICH, 350 people have hypertensive hemorrhage.

Causes

Intracerebral hemorrhage is usually caused by:

  • high blood pressure

If your blood pressure rises above normal level, 120/80 mm Hg, intracerebral hemorrhage may occur without any awareness.

  • trauma or head
    injury

If you have a skull fracture or get shot in the head, your brain gets injured and bleeds.

  • tumor

Highly vascular
tumors such as angiomas and metastatic tumors can bleed into the brain tissue.

  • use of blood
    thinners

Clots prevention
drugs such as coumadin, heparin, and warfarin may cause ICH.

  • ruptured
    cerebral aneurysm

It is a bulge or weakening of an artery
wall.

  • drugs

Alcohol, cocaine and other illegal drugs can cause ICH. Particularly, for older adults who take an anticoagulant or an antiplatelet drug, such as aspirin, even mild head trauma can cause a hematoma.

  • blood disorders

hemophilia, sickle cell anemia, DIC, thrombocytopenia can contribute to ICH.

Symptoms

Symptoms of an intracerebral hemorrhage
may be obvious right after a blow to your head or appear weeks later or longer.
As time passes by, common symptoms may include:

  • Increasing headache, nausea, and vomiting
  • Drowsiness and progressive loss of consciousness
  • Dizziness
  • Confusion
  • Unequal pupil size
  • Slurred speech
  • Sudden weakness or numbness of the face or limbs  
  • Temporary loss of vision

As more blood fills your brain, other symptoms
may become apparent, such as:

  • Lethargy
  • Seizures
  • Unconsciousness
  • partial or complete paralysis.

Diagnosis

It’s difficult to diagnose an
intracerebral hemorrhage, because its symptoms aren’t so apparent in most patients
at the initial stage. The diagnostic procedure usually begins with an inquiry about the patient’s symptoms
and medical history, and a physical
examination
of the patient’s health condition. Next, diagnostic tests will be performed for further assessment,
including:

  • Computed Tomography (CT) scan
  • Magnetic resonance imaging (MRI) scan
  • Angiogram

Treatment

Recommended ways to treat intracerebral hemorrhage are medications and surgery.

Medications

Doctors may prescribe the following medications:

  • nimodipine(Nymalize)
  • phenytoin(Dilantin)
  • painkillers
  • blood pressure drugs
  • anti-anxiety medicines
  • vitamin K
  • fresh frozen plasma

Surgery

Optional
surgeries include:

  • Craniotomy
  • Surgical drainage
  • Stereotactic clot aspiration

Keywords: intracerebral hemorrhage.

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