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14-September-2008 12:50:26 - hemorrhage Cerebral hemorrhage Classification and external resources Intracerebral hemorrhage ICD-10 I61. ICD-9 431 MeSH D002543 A cerebral hemorrhage or intracerebral hemorrhage, ICH, is a subtype of intracranial hemorrhage that occurs within the brain tissue itself. Intracerebral hemorrhage 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.1 A cerebral hemorrhage is an intra-axial hemorrhage; that is, it occurs within the brain tissue rather than outside of it. The other category of intracranial hemorrhage is extra-axial hemorrhage, 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 hemorrhages: intraparenchymal hemorrhage and intraventricular hemorrhages. As with other types of hemorrhages within the skull, intraparenchymal bleeds are a serious medical emergency because they can increase intracranial pressure. The mortality rate for intraparenchymal bleeds is over 40%.2 Contents 1 Causes 2 Symptoms 3 Diagnosis 4 Prognosis 5 References 6 External links Causes CT scan showing hemorrhage in the posterior fossa CT scan showing hemorrhage in the posterior fossa1 Intracerebral bleeds are the second most common cause of stroke, accounting for 30-60% of hospital admissions for stroke.1 High blood pressure raises the risk of spontaneous intracerebral hemorrhage by two to six times.1 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, acceleration-deceleration trauma,345 rupture of an aneurysm or arteriovenous malformation AVM, and bleeding within a tumor. A very small proportion is due to cerebral venous sinus thrombosis. Symptoms Patients with intraparenchymal bleeds have symptoms that correspond to the functions controlled by the area of the brain that is damaged by the bleed.6 Other symptoms include those that indicate a rise in intracranial pressure due to a large mass putting pressure on the brain.6 Diagnosis Spontaneous ICH with hydrocephalus on CT scan Spontaneous ICH with hydrocephalus on CT scan1 Intraparenchymal hemorrhage 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. The tissue surrounding a bleed is often less dense than the rest of the brain due to edema, and therefore shows up lighter on the CT scan. Prognosis The risk of death from an intraparenchymal bleed in traumatic brain injury is especially high when the injury occurs in the brain stem.2 Intraparenchymal bleeds within the medulla 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.3 This kind of hemorrhage can also occur in the cortex or subcortical areas, usually in the frontal or temporal lobes when due to head injury, and sometimes in the cerebellum.37 For spontaneous ICH seen on CT scan, the death rate mortality is 34-50% by 30 days after the insult.1 References ^ a b c d e f Yadav YR, Mukerji G, Shenoy R, Basoor A, Jain G, Nelson A 2007. Endoscopic management of hypertensive intraventricular haemorrhage with obstructive hydrocephalus. BMC Neurol 7: 1. doi:10.1186/1471-2377-7-1. PMID 17204141. PMC:1780056. ^ a b Sanders MJ and McKenna K. 2001. Mosby's Paramedic Textbook, 2nd revised Ed. Chapter 22, Head and Facial Trauma. Mosby. ^ a b c McCaffrey P. 2001. The Neuroscience on the Web Series: CMSD 336 Neuropathologies of Language and Cognition. California State University, Chico. Retrieved on June 19, 2007. ^ Orlando Regional Healthcare, Education and Development. 2004. Overview of Adult Traumatic Brain Injuries. Retrieved on 2008-01-16. ^ Shepherd S. 2004. Head Trauma. Emedicine.com. Retrieved on June 19, 2007. ^ a b Vinas FC and Pilitsis J. 2006. Penetrating Head Trauma. Emedicine.com. ^ Graham DI and Gennareli TA. Chapter 5, Pathology of Brain Damage After Head Injury Cooper P and Golfinos G. 2000. Head Injury, 4th Ed. Morgan Hill, New York. External links Parent friendly information on IVH in premature babies from The Hospital for Sick Children LPCH on Intraventricular v d e Cerebrovascular diseases I60-I69, 430-438 Intracranial hemorrhage extra-axial Epidural, Subdural, Subarachnoid Cerebral/Intra-axial Intraventricular Stroke hemorrhagic Ischemia/infarction Stroke ischemic - TIA - Brain ischemia - Vertebrobasilar insufficiency Subclavian steal syndrome - Cerebral venous sinus thrombosis Carotid artery stenosis Anterior spinal artery syndrome Binswanger's disease Lacunar stroke Other/general Cerebral aneurysm - Moyamoya disease v d e Neurotrauma Traumatic brain injury Intracranial hemorrhage · Intraparenchymal hemorrhage · Subdural hematoma · Epidural hematoma · Subarachnoid hemorrhage · Intraventricular hemorrhage · Brain herniation · Cerebral contusion · Concussion · Post-concussion syndrome · Second-impact syndrome · Dementia pugilistica · Diffuse axonal injury · Shaken baby syndrome · Penetrating head injury · Brain herniation Spinal cord injury Cauda equina syndrome · Paraplegia · Quadriplegia Retrieved from http://en..org/wiki/Cerebral_hemorrhage Categories: Neurotrauma Views Article Discussion this page History Personal tools Log in / create account Navigation Main page Contents Featured content Current events Random article Search Go Search Interaction Community portal Recent changes Contact Donate to Help Toolbox What links here Related changes Upload file Special pages Printable version Permanent link Cite this page Languages Deutsch Italiano Nederlands 日本語 עברית This page was last modified on 13 September 2008, at 09:06
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