Intracerebral Haemorrhage

Posted by e-Medical PPT Wednesday, September 15, 2010
Intracerebral haemorrhage is a subtype of intracranial haemorrhage that occurs within the brain paranchymal itself.Intracerebral haemorrhage can be caused by brain trauma, or it can occur spontaneously in hemorrhagic stroke.Non-traumatic intracerebral haemorrhage is a spontaneous bleeding into the brain tissue.A cerebral haemorrhage can be an intra-axial haemorrhage(within the brain tissue) and extra-axial haemorrhage, such as epidural, subdural, and subarachnoid hematomas, which all occur within the skull but outside of the brain tissue. There are two main kinds of intra-axial haemorrhages: intraparenchymal haemorrhage and intraventricular haemorrhages.Intracerebral bleeds are the second most common cause of stroke.Hypertension raises the risk of spontaneous intracerebral hemorrhage by two to six times.More common in adults than in children, intraparenchymal bleeds due to trauma are usually due to penetrating head trauma, but can also be due to depressed skull fractures, some may experience intense headaches. They may also go in to a coma before the bleed is noticed. A hit to the head or fracture to the skull may also cause this bleed. acceleration-deceleration trauma,rupture of an aneurysm or arteriovenous malformation (AVM), and bleeding within a tumor. A very small proportion is due to cerebral venous sinus thrombosis.Intraparenchymal bleeds within the medulla oblongata are almost always fatal, because they cause damage to cranial nerve X, the vagus nerve, which plays an important role in blood circulation and breathing.
Intraparenchymal haemorrhage can be recognized on CT scans because blood appears brighter than other tissue and is separated from the inner table of the skull by brain tissue.
Surgery is required if the hematoma is greater than 3 cm, if there is a structural vascular lesion or lobar haemorrhage in a young patient.

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