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
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
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
- 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. According to the Mayfield Clinic, men are at
higher risk than women, as are middle-aged people of Japanese or
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
- sudden onset of severe headache
- trouble swallowing
- trouble with vision in one or
- loss of balance and coordination,
- trouble with language skills
(reading, writing, speaking, understanding)
- nausea, vomiting
- apathy, sleepiness, lethargy,
loss of consciousness
- confusion, delirium
This is a serious medical condition. If
you or someone near you is having symptoms of stroke, call 911 immediately.
How Is Intracerebral Hemorrhage Diagnosed?
If you have some symptoms of ICH, a doctor
will perform a neurological exam. Imaging tests determine if you’re having an
ischemic stroke (blockage) or a hemorrhagic stroke (bleeding).
Diagnostic testing for ICH may include a CT
scan. This type of test creates images of the brain, which can detect skull
fractures or confirm bleeding. MRI
may help your doctor see the brain more clearly to better identify the cause of
the bleeding. An angiogram uses
X-ray technology to take pictures of blood flow within an artery. Blood tests can
identify immune system disorders, inflammation, and blood clotting problems
that can cause bleeding in the brain.
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
- problems with swallowing
- vision loss
- difficulty with sensations or
movements on one side of the body
- cognitive dysfunction (memory
loss, difficulty reasoning), confusion
- swelling on the brain
- depression, emotional problems
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
Recovery following ICH differs greatly from
person to person, and will depend on a variety of factors, including your age
and overall health, the location of the hemorrhage, and the extent of the
Some people may take months or years to
recover. Most ICH patients have some long-term disability. In some cases,
around the clock or nursing home care may be necessary.
Stroke support groups can help people and
families cope with long-term care. Your doctor or hospital can provide
information about support groups that meet in your area.