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Deep intracerebral hemorrhage
Alternative namesHemorrhage - intracerebral (deep); Intracranial bleed
DefinitionDeep intracerebral hemorrhage is a type of stroke caused by bleeding within the deep structures of the brain (thalamus, basal ganglia, pons, and cerebellum).
Causes, incidence, and risk factors
Intracerebral hemorrhage can affect any person regardless of age, sex, or race, though it is more common in older people. Bleeding can occur in any part of the brain, and blood may accumulate in the tissues or in the subarachnoid space (space between the brain and the membranes covering the brain, the meninges).
Bleeding may be isolated to part of one cerebral hemisphere ( lobar intracerebral hemorrhage ) or may occur in other brain structures such as the thalamus, basal ganglia, pons, or cerebellum. Intracerebral hemorrhage that is not caused by trauma most commonly occurs in the basal ganglia.
When it is not caused by one of these conditions, intracerebral hemorrhage is most commonly associated with high blood pressure ( hypertensive intracerebral hemorrhage ). In some cases, no cause can be found.
Signs and tests
Neurological examination may indicate increased intracranial pressure or decreases in specific brain functions. The specific pattern of symptoms and function changes may indicate which of the deep brain tissues are affected. For example, sudden nausea , vomiting , loss of balance , headache , and rapid decrease in consciousness may indicate a bleed in the cerebellum or brainstem.
Eye examination may show swelling of the optic nerve from pressure in the brain, or there may be changes in eye movement. Abnormal reflexes may be present.
Deep intracerebral hemorrhage is a severe condition requiring prompt medical attention -- even if symptoms are episodic. It can develop quickly into a life-threatening situation.
Treatment goals include life support measures and control of symptoms. Treatment varies depending on the specific location, extent, and cause of the bleeding .
Other treatments may be recommended, depending on the condition of the person and the symptoms that develop.
The outcome is highly variable. Prognosis depends on the degree of swelling and size of the hematoma. Death may occur quickly despite prompt medical treatment.
Recovery may occur completely or with any level of permanent loss of brain functions. Medications, surgery, or other treatments may have severe side effects.
Calling your health care providerCall your health care provider if severe headache with nausea , vomiting , decreased vision , numbness , or tingling occurs.
Go to the emergency room or call the local emergency number (such as 911) if other symptoms of deep intracerebral hemorrhage develop. Emergency symptoms include difficulty breathing , seizures , loss of ability to move or swallow, sudden loss of sensations, sudden change in mental state , and loss of consciousness .
Treatment or control of causative and risk-related disorders may reduce the risk of developing intracerebral hemorrhage . High blood pressure should be treated as appropriate. Do not stop taking medications unless advised to do so by the health care provider.
If you are taking a blood thinner (such as coumadin), follow your doctor's instructions on how to take the medicine and when to have blood tests for monitoring the medication.
Update Date: 7/29/2002Joseph V. Campellone, M.D., Division of Neurology, Cooper Hospital/University Medical Center, Camden, NJ. Review provided by VeriMed Healthcare Network.
Last updated: Tue, 06 Jan 2009 00:20:03 GMT