What is an Intracerebral Hemorrhage?

Intracerebral hemorrhage (ICH), also known as cerebral hemorrhage, is bleeding within the brain caused by a burst blood vessel. The prognosis for patients with this condition varies, depending on the cause and location of the bleed, but can be quite poor for many patients due to the damage to the brain caused by the bleed. Black patients are more likely to develop an intracerebral hemorrhage, with incidence of this condition about twice as common in people of African origin.

A blood vessel can burst in the brain as a result of a chronic degenerative disease like diabetes or high blood pressure. Bursts can also occur spontaneously. The blood leaking into the brain causes pressure to rise, damaging the cells of the brain. Treatment for an intracerebral hemorrhage requires inserting a shunt to provide drainage for the fluid and to keep pressure levels stable, along with respiratory support if the patient is having trouble breathing. Surgery may also be considered as an option.

Symptoms vary, depending on the location of the hemorrhage. Some patients develop stroke-like symptoms, such as weakness along one side, confusion, dizziness, nausea, and vomiting. Patients can also develop an altered level of consciousness, have difficulty balancing, and display other neurological deficits, such as forgetting words or having difficulty processing information. Headaches can also be associated with this condition, although if the patient experienced a head injury, it may be difficult to trace the origins of the headache.

Diagnosis involves medical imaging of the brain to learn more about what is going on inside. This must be done quickly to identify the intracerebral hemorrhage as rapidly as possible. The longer treatment is delayed, the poorer the outcome for the patient. Permanent damage can occur if interventions are not provided in a timely fashion. The same applies to delays with other neurological emergencies, such as strokes, and it is a compelling reason to seek medical attention immediately for any abrupt changes in neurological status that might indicate a problem inside the brain.

Some patients make a complete recovery from an intracerebral hemorrhage. This occurs in cases where the bleed is small, caught early, or located in a fortuitous spot. Other patients may recover but experience neurological symptoms for life, requiring physical therapy and other treatments to help them adjust. In other cases, especially when the hemorrhage is located in the brain stem, there is a chance that recovery is not possible.