Intracerebral Hemorrhage: Causes, Symptoms, Investigations, Treatment- Medications
An intracerebral hemorrhage is a serious medical condition where there is rupture of one or more blood vessels in the brain causing bleeding in the brain. Immediate medical attention should be sought in this condition. The most common cause of this condition is traumatic brain injury.
Causes of Intracerebral Hemorrhage
- Traumatic head injury such as occurring in falls, road accidents and sports.
- High blood pressure.
- Blood vessel abnormalities such as aneurysm or vascular malformation.
- Protein deposits in the blood vessel walls.
- Blood /bleeding disorders such as disseminated intravascular coagulation, decreased levels of blood platelets, hemophilia, leukemia or sickle cell anemia.
- Liver disease.
- Use of blood thinners such as warfarin or aspirin.
- Brain tumors or cerebral amyloid angiopathy.
Symptoms of Intracerebral Hemorrhage
- Intense headache.
- Abnormal sense of taste.
- Changes in the vision.
- Change in level of consciousness such as confusion, feeling sleepy, lethargic etc.
- Loss of coordination and balance.
- Life threatening symptoms are: Difficulty in breathing, difficulty in speaking or understanding speech, swallowing, reading or writing, loss of consciousness, numbness or weakness in the limbs on one side and seizures.
Investigations for Intracerebral Hemorrhage
- Head CT scan
- Head MRI or MRA
- Cerebral angiography or spiral CT angiography of the head.
- Complete blood count (CBC)
- Bleeding time
- Kidney function tests
- Liver function tests
- Prothrombin time ( PT) or partial thromboplastin time ( PTT).
- Platelet count
Treatment of Intracerebral Hemorrhage
- Immediate medical attention should be sought. If medical care is delayed, it can prove to be a life threatening condition.
- Treatment depends on the cause, location and the amount of bleeding.
- The aim of treatment is to halt the bleeding and to relieve the build-up of pressure in the skull.
- Medications such as anticonvulsants can be given to control seizures, corticosteroids or diuretics help in reducing the swelling and painkillers are given to alleviate the pain.
- Surgery is required if there is bleeding in the cerebellum. Surgery is also done to repair or remove the structures which are causing the bleeding e.g. arteriovenous malformation or cerebral aneurysm.
- After the surgery, the patient is monitored closely for several weeks.
- Additional tests are done to ensure that the bleeding has stopped and to check for any brain damage.
- Patient requires long-term medication and regular check-ups once discharged from the hospital.
- Complications of intracerebral hemorrhage include: Permanent loss of any brain function, hemorrhagic stroke and side effects from medications used in treating this condition.