intracerebral%20hemorrhage
INTRACEREBRAL HEMORRHAGE
Intracerebral hemorrhage is the sudden burst of blood into the brain tissue itself.
It causes sudden onset of focal neurological deficit.
The focal neurologic findings are related to the anatomic location, size and speed of development of intracerebral hemorrhage.
Neurological deficit usually progresses over a minute to an hour.
Rapid recognition and diagnosis of intracerebral hemorrhage are essential because of its frequently rapid progression.

Surgical Intervention

  • The usefulness of surgical therapy, in most patients with intracerebral hemorrhage (ICH), remains controversial
    • Surgery may limit mechanical compression and neurotoxic effects of blood but surgical risks in a bleeding patient may be greater
  • Minimally invasive procedures including stereotactic- or endoscopic-guided evacuation with or without thrombolysis is considered investigational
  • Very early craniotomy may increase the risk of recurrent bleeding
  • For patients with hydrocephalus with decreased level of consciousness, ventricular drainage may be a reasonable option
  • Ventricular drainage alone rather than surgical evacuation is not recommended

Surgical Candidates

  • Cerebellar hemorrhage >3 cm with the following:
    • Neurological deterioration or
    • Brain stem compression and/or hydrocephalus from ventricular obstruction
  • Lobar clots >30 mL & within 1 cm of the surface
  • Intracerebral hemorrhage with mass effect lesion if surgically accessible and patient has chance of good outcome
  • Young patients with moderate-large lobar hemorrhage and who are deteriorating clinically
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Cardiology - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
3 days ago
Less focus must be given on pretreatment blood pressure (BP) levels, which rarely predict future untreated BP levels or rule out capacity to benefit from BP lowering in high cardiovascular risk patients, according to recent study. Focus must be directed instead on prompt, empirical treatment to maintain lower BP for individuals with high BP or high risk.
16 Nov 2018
Atrial fibrillation appears to be the strongest determinant of stroke over 48 years of follow-up in males, a study has found.
15 Nov 2018
Psychological functioning consistently predicts symptom severity and health-related quality of life (hr-QOL) in atrial fibrillation (AF) patients with preserved left ventricular function, a recent study has found.
Audrey Abella, 16 Nov 2018
Supplementation with either omega-3 fatty acids (ie, fish oil) or vitamin D did not reduce the incidence of major cardiovascular (CV) events (ie, composite of myocardial infarction [MI], stroke, and CV death) or total invasive cancer, according to the VITAL* trial presented at AHA 2018.