What Is Intracerebral Hemorrhage?

Intracerebral hemorrhage (ICH) is when blood suddenly bursts into brain tissue, causing damage to the brain.

Symptoms usually appear suddenly during ICH. They include headache, weakness, confusion, and paralysis, particularly on one side of the body. The buildup of blood puts pressure on the brain and interferes with its oxygen supply. This can quickly cause brain and nerve damage.

This is a medical emergency requiring immediate treatment. ICH is not as common as ischemic stroke (when a blood vessel is blocked by a clot), but it’s more serious.

Treatment generally involves surgery to relieve the pressure from the accumulation of blood and to repair damaged blood vessels. Long-term treatment depends on the hemorrhage location and the amount of damage. Treatment may include physical, speech, and occupational therapy. Most people have some level of permanent disability

What Are the Causes of Intracerebral Hemorrhage?

High blood pressure is the most common cause of intracerebral hemorrhage. In younger people, another common cause is abnormally formed blood vessels in the brain. Other causes include:

• head injury or trauma
• ruptured cerebral aneurysm (weak spot in a blood vessel that bursts)
• arteriovenous malformation (a grouping of malformed blood vessels in the brain that disrupts normal blood flow)
• use of blood thinners
• bleeding tumors
• cocaine use (can cause severe hypertension and lead to hemorrhage)
• bleeding disorders (e.g., hemophilia, sickle cell anemia)

Anyone can have an intracerebral hemorrhage, but your risk increases with age.

What Are the Symptoms of Intracerebral Hemorrhage?

Symptoms of ICH include:

• sudden weakness, tingling, or paralysis in the face, arm, or leg, especially if it occurs on only one side of the body
• sudden onset of severe headache
• trouble swallowing
• trouble with vision in one or both eyes
• loss of balance and coordination, dizziness
• trouble with language skills (reading, writing, speaking, understanding)
• nausea, vomiting
• apathy, sleepiness, lethargy, loss of consciousness
• confusion, delirium

What Are the Complications of Intracerebral Hemorrhage?

Depending on the location of the hemorrhage and how long your brain was without oxygen, complications may include:

• impaired language skills
• fatigue
• problems with swallowing
• vision loss
• difficulty with sensations or movements on one side of the body
• pneumonia
• cognitive dysfunction (memory loss, difficulty reasoning), confusion
• swelling on the brain
• seizures
• depression, emotional problems
• fever

How Is Intracerebral Hemorrhage Treated?

Treatment within the first three hours of the onset of symptoms generally results in a better outcome.

Surgery can relieve pressure on the brain and repair torn arteries. Certain medications can help manage symptoms, such as painkillers to ease severe headaches. Antianxiety drugs may be necessary to control blood pressure. If your doctor determines that you’re at risk for seizures, antiepileptic drugs may be necessary.

Long-term treatment will be needed to overcome symptoms caused by damage to the brain. Depending on your symptoms, treatment may include physical and speech therapy to help restore muscle function or improve communication. Occupational therapy may help a person regain certain skills and independence by practicing and modifying everyday activities.

How Can I Prevent Intracerebral Hemorrhage?

You can decrease your chances of ICH by:

• not smoking
• treating heart disease
• treating high blood pressure
• keeping diabetes under control
• maintaining a healthy lifestyle