Intracerebral hemorrhage (ICH)

Intracerebral hemorrhage (ICH), also known as a hemorrhagic stroke, is a medical emergency where bleeding occurs within the brain tissue itself. Unlike ischemic strokes, caused by blocked blood flow, ICH is caused by a ruptured blood vessel. This results in sudden internal bleeding and potentially severe damage to the brain.

Recognizing the symptoms of ICH and seeking immediate medical attention are crucial for improving outcomes.

Call 911 immediately if you or someone you know has symptoms of an intracerebral hemorrhage.

Causes and risk factors of intracerebral hemorrhage

Several factors increase your risk of ICH, including:

• High blood pressure: Chronic high blood pressure is the main cause of ICH.
• Age: An ICH is more common in people over the age of 55.
• Gender: Men, or those assigned male at birth, are more likely to have an ICH than women.
• Head trauma: Injuries to the brain may damage blood vessels, leading to later bleeding in the brain.
• Blood thinners: Certain medications can increase bleeding risk.
• Liver disease: Can affect blood clotting and increase ICH risk.
• Alcohol abuse: Chronic alcohol consumption weakens your blood vessels.

Specific underlying conditions can also cause ICH, including:

• Arteriovenous malformations (abnormal connections between arteries and veins)
• Brain tumors
• Head injuries

Preventive measures play a crucial role in minimizing the risk of ICH. Managing and controlling high blood pressure, addressing underlying health conditions and adopting a healthy lifestyle contribute to prevention.

Staying up to date on your physical exams can aid in early detection and identifying potential risk factors.

Intracerebral hemorrhage symptoms

Symptoms of ICH include:

• Confusion
• Headache
• Lethargy
• Loss of consciousness
• Nausea or vomiting
• Temporary blindness
• Sudden weakness or numbness (often on one side)
• Seizures

Diagnosis of intracerebral hemorrhage

If an ICH is suspected, your provider will perform a physical examination and order digital imaging tests, including:

• CT scan
• MRI
• X-rays

Treatment options for intracerebral hemorrhage

Treatment plans for ICH aim to address the hematoma and prevent further damage. Treatment options may include:

• Surgery: In some cases, traditional surgery may be needed to drain the blood or repair damaged blood vessels.
• Draining the fluid that surrounds the brain: This creates room for the hematoma to expand without damaging brain cells.
• Medication: Drugs are used to control blood pressure, seizures or headaches.
• Catheter: A long, thin tube is threaded through blood vessels until it reaches the affected area.
• Rehabilitation therapy: Therapies such as physical therapy and speech therapy may help you regain brain functions – such as the ability to speak – affected by the bleeding.

Recovery after intracerebral hemorrhage

ICH recovery requires a comprehensive approach, including rehabilitation. The length of recovery depends on a range of factors, including the size of the bleed, how quickly treatment was administered and any underlying conditions.

Rehabilitation programs such as physical therapy, occupational therapy and speech therapy may be included in the recovery plan by your provider.

Complications of intracerebral hemorrhage

Associated complications with ICH may include long-term neurological deficits, cognitive impairments and challenges in daily functioning.

Timely medical care with rehabilitation efforts can help reduce complications and improve overall outcomes for individuals affected by ICH.