Intracerebral Hemorrhage (ICH)

Intracerebral hemorrhage (ICH) is the second most common subtype of stroke (when a blood vessel that carries oxygen to the brain is blocked or bursts) and is usually caused by degeneration of blood vessels that make them prone to rupture. This damages the brain and leads to neurological disability.

What is an intracerebral hemorrhage?
Intracerebral hemorrhage is caused by degeneration of blood vessels, whether artery or vein, in the brain that leads them to rupture causing bleeding in the brain.
The most common cause of intracerebral hemorrhage is hypertension (high blood pressure), but since hypertension by itself often causes no symptoms, a person with intracerebral hemorrhage may not be aware that they have high blood pressure or that it needs to be treated. Other causes include head trauma, infections, brain tumors, blood clotting deficiencies and abnormalities in blood vessels.
  • Age
  • Hypertension (high blood pressure)
  • Diabetes
  • Dyslipidemia (high blood cholesterol)
  • Heart disease
  • Smoking
  • Obstructive sleep apnea
  • Alcohol consumption
  • History of heart disease, cardiovascular disease, or stroke
  • History of brain aneurysm
  • Certain diseases, such as bleeding disorders or sickle cell disease
  • Taking blood-thinning medications such as warfarin (Coumadin)
  • Lack of exercise
  • Obesity
The symptoms of intracerebral hemorrhage are quite similar to the symptoms of ischemic stroke, such as weakness or numbness in the limbs of one side of the body, acute speech difficulties, and acute dizziness. The most distinct symptom of intracerebral hemorrhage is an acute severe headache. A computed tomography (CT) scan can differentiate between ischemic stroke and intracerebral hemorrhage.
The first step in diagnosing intracerebral hemorrhage is taking the patient’s history, but the most important diagnostic tool is a computed tomography (CT) scan of the brain to find the location of the bleeding. This helps the doctor reach a diagnosis and assess the cause of the bleeding. For example, if the bleeding occurs in the superficial part of the brain or below the meninges, it may be due to the trauma or from rupture of abnormal blood vessels in the brain. If the bleeding occurs in the middle part of the brain, it is usually caused by hypertension.
The treatment of intracerebral hemorrhage depends on where the bleeding is and the cause of the bleeding. Normally, treatment varies with the cause and location of bleeding.
Possible Complications of Treatment
Complications depend on location and severity of bleeding in the brain.
A person may reduce the risk of developing an intracerebral hemorrhage by:
  • Undergo an annual health check-up for early detection and management or treatment risk factors.
  • Maintain normal blood pressure, blood sugar levels, and blood cholesterol levels.
  • Eat well-balanced meals and avoid excessive salt, sugar, and fat.
  • Avoid smoking and drinking alcohol.
  • Seek medical attention for abnormal symptoms.

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