Intracerebral haemorrhage (ICH) is a type of stroke that refers to bleeding from a diseased blood vessel within the brain. The blood that leaks into the brain results in a sudden increase in pressure and can cause tissue destruction. Rapid increase in the amount of blood leakage can cause extreme build-up in pressure and can lead to unconsciousness or even death. This is a serious condition requiring emergency medical care.
The most common cause of ICH is high blood pressure. The less common causes include head trauma, arteriovenous malformations (abnormally formed blood vessels in the brain), blood disorders, a tumour, or the use of blood thinning medication.
Symptoms include headache, confusion, dizziness, trouble with vision and swallowing, seizures, weakness or paralysis affecting one side of the body. Speech, vision, cognition and movement are affected depending on the area affected and extent of brain damage.
When you present to the clinic with the above symptoms, your doctor thoroughly reviews your medical history and performs a complete physical and neurological examination. Imaging tests such as CT or MRI scans are ordered to view the blood vessels and structures of the brain. An angiogram, an imaging test that uses a special dye and X-ray images to detect blockages in the blood vessels may also be ordered. Blood tests may help identify other conditions which may cause bleeding such as clotting disorders, immune disorders, and inflammation.
ICH can be managed either medically or surgically depending on the cause of bleeding. Surgery is recommended to remove the blood clot and prevent or stop bleeding. The clot may be aspirated using a needle under image guidance or removed by craniotomy (a bony opening that is cut through the skull to access the brain and remove the clot). Medications are prescribed to help alleviate symptoms such as headache, anxiety, and seizures. You will be monitored closely in an intensive care unit after ICH for pressure changes within the brain. Rehabilitation and support are offered to restore any lost functions and to help cope with any long-term disability.