A19. Intracerebral bleedings Flashcards
Intracerebral hemorrhage (ICH) definition
- Bleeding within the brain parenchyma
Intracerebral hemorrhage is most common in patients with
- hypertension
Intracerebral hemorrhage is a type of
- type of hemorrhagic stroke,
accounts for 10% of strokes
30 day prognosis in patients diagnosed with Intracerebral bleedings
approximately half of patients
die within 30 days.
Hemorrhagic stroke
definition
Rupture of a blood vessel within the brain or the cerebrospinal fluid
Hemorrhagic stroke subtypes
- Intracerebral hemorrhage (intraparenchymal hemorrhage): bleeding within the brain parenchyma
- Subarachnoid hemorrhage: bleeding into the subarachnoid space
- Intraventricular hemorrhage: bleeding within the ventricles
Intracerebral hemorrhage can it rupture? what happens?
Can rupture through to the cortical surface to produce
* associated SAH (Subarachnoid hemorrhage )
or
* into the ventricular system. (30%)
Intracerebral hemorrhage most commonly affects which structures of the brain?
Most commonly affects the deep structures of the brain
common sites of intracerebral hemorrhage in hypertensive patients
hypertensive patients 70% occur in the basal ganglia/thalamic region
common sites of intracerebral hemorrhage In normotensive patients
- 37% occur in basal ganglia/thalamic region
- frontal,
- temporal,
- parieto-occipital,
- cerebellar and
- pontine areas.
Supratentorial hematomas can have
mass effect
(sudden headache with deteriorating consciousness)
and focal signs.
Intracerebral hemorrhage in Basal ganglia symptoms
Hemiparesis,
sensory loss,
eye deviation
symptoms of ICH(intracerebral) in Thalamus
- Sensory loss,
- later hemiparesis,
- gaze disturbance
Lobar ICH(intracerebral) prognosis
Better prognosis, intraventricular bleeding is rare
Cerebellar ICH (intracerebral)
- Nausea
- ataxia,
- dizziness,
- signs of brainstem compression (30% mortality)