Intracerebral Hemorrhage

About Intracerebral Hemorrhage

General Information

• An intracerebral hemorrhage (ICH) is a sudden leakage of blood into brain tissue itself. The blood leaks out of a very small artery and pushes into the brain tissue, causing injury to the brain and symptoms of a stroke.
• Long-standing high blood pressure unknown to the patient often causes ICH. Other causes include collections of abnormal blood vessels called arteriovenous malformation (AVM), aneurysms, tumors, traumatic brain injury, or infections.

Symptoms

• Symptoms usually involve sudden onset of stroke. Stroke symptoms include sudden weakness, blindness, loss of speech and numbness on half of the body.
• Other symptoms also can include seizure and loss of consciousness. Headache can also occur but is not a prominent feature.

Diagnosis

• Diagnosis usually begins with a neurological exam and includes computed tomography (CT) and magnetic resonance imaging (MRI) scans of the brain.
• Additional tests may include an angiogram, an electroencephalogram (EEG), and cerebral blood flow tests. Blood tests can detect defects in the blood clotting system and signs of inflammation or immune system disorders.

Treatment

• Treatment includes surgically measuring and correcting pressure on the brain by inserting a tube and draining excess blood and the cerebrospinal fluid that normally bathes the brain.
• Control of blood pressure and support of the lungs and respiratory system are important features of intensive care for these patients.
• If an abnormal blood vessel or AVM is found, surgery may be required to correct and prevent future brain hemorrhage.
• If a tumor is found, surgery may be required to remove it.

Outcome

• Factors that affect prognosis after intracerebral hemorrhage are the size of the hematoma, the patient's age, leakage of the blood into the ventricles, and the initial neurological state of consciousness.
• The prognosis is generally poor after an intracerebral hemorrhage, although some patients can recover most function. Long-term mental and physical disability usually occurs.

The Neuro-ICU cares for patients with all types of neurosurgical and neurological injuries, including stroke, brain hemorrhage, trauma and tumors. We work in close cooperation with your surgeon or medical doctor with whom you have had initial contact. Together with the surgeon or medical doctor, the Neuro-ICU attending physician and team members direct your family member's care while in the ICU. The Neuro-ICU team consists of the bedside nurses, nurse practitioners, physicians in specialty training (Fellows) and attending physicians. UCLA Neuro ICU Family Guide