Intracerebral Hemorrhage

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.

Symptoms of an intracerebral hemorrhage depend on the location and amount of bleeding. They may include:

• headache
• decreased sensation, numbness, tingling, or paralysis in certain parts of the body
• inability to talk, known as aphasia
• change in the level of consciousness, including drowsiness, unconsciousness, and coma
• nausea and vomiting
• unsteady walking, known as ataxia
• shortness of breath, or difficulty breathing
• dizziness
• difficulty with eye movement
• visual impairment

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

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.

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.

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

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

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.

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.

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.

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.