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Intraparenchymal Brain Hemorrhage - Intracerebral Hemorrhage


Overview, Causes, & Risk Factors

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.

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
  • drug abuse, such as cocaine abuse
  • head injury
  • brain tumors
  • abnormal bleeding tendencies
  • treatment with medications that thin the blood, such as anticoagulants or thrombolytics

  • Symptoms & Signs

    What are the signs and symptoms of the condition?

    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
  • problems with eye movement
  • visual impairment

  • Diagnosis & Tests

    How is the condition diagnosed?

    The history and physical exam are the first steps in diagnosis of intracerebral hemorrhage. X-ray 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 x-ray tests can show the location and amount of the blood in the brain.


    Prevention & Expectations

    What can be done to prevent the condition?

    Proper control of high blood pressure with medications can help prevent some intracerebral hemorrhages. Avoiding cocaine can also help prevent this condition. A person who takes anticoagulant medications for long periods of time must be monitored. Many cases cannot be prevented.

    What are the long-term effects of the condition?

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

    What are the risks to others?

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


    Treatment & Monitoring

    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 is sometimes done to remove blood, abnormal blood vessels, or a tumor. Medications may be used to reduce swelling, prevent seizures, lower blood pressure, and control pain.

    What are the side effects of the treatments?

    Surgery carries a risk of further bleeding, infection, allergic reaction to the anesthesia, or even death. Side effects of medications vary, but may include allergic reactions.

    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.

    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.


    Attribution

    Author:Adam Brochert, MD
    Date Written:
    Editor:Duff, Ellen, BA
    Edit Date:09/21/00
    Reviewer:Gail Hendrickson, RN, BS
    Date Reviewed:07/03/01

    Sources

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


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