Intracerebral Hemorrhage

Intracerebral Hemorrhage is a topic covered in the 5-Minute Emergency Consult.

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Basics

Description

Hemorrhage into brain parenchyma:
  • Compression of brain tissues
  • Secondary injury results from:
    • Cerebral edema
    • Increased intracranial pressure (ICP)
    • Potential of brain herniation

Etiology

Intracerebral hemorrhage can occur spontaneously or from trauma:
  • Uncontrolled or acute HTN (most common)
  • Vascular malformations:
    • Arteriovenous malformation
    • Venous angiomas
    • Ruptured cerebral aneurysms
  • Neoplasm (particularly melanoma and glioma)
  • Anticoagulant therapy (warfarin, heparin)
  • Thrombolytic agents
  • Illicit drugs (cocaine, amphetamines)
  • Bleeding disorders (hemophilia)
  • Cerebral amyloid angiopathy
  • Traumatic hemorrhage secondary to blunt or penetrating injury

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