Hypertensive intracerebral hemorrhage

Alternative names:

hemorrhage - intracerebral (hypertensive)

Definition:

A condition where there is bleeding within the brain, caused by changes in the blood vessels of the brain as a result of high blood pressure.

Causes, incidence, and risk factors:

Intracerebral hemorrhage (from any cause) occurs in about 2 out of 1,000 people. It can affect any person regardless of age, sex, or race but is most common in older individuals.

Hypertensive intracerebral hemorrhage is caused by the effects of high blood pressure. When the blood pressure is chronically high, the blood vessels may develop small weakened areas (microaneurysms) from the constant pressure on the vessel walls. These microaneurysms can leak blood into the tissues. Intracerebral bleeding associated with hypertension most commonly occurs in the tissues of the basal ganglia but may occur in any part of the brain. Blood irritates the brain tissues, causing swelling (cerebral edema). The blood collects into a mass (hematoma). Both swelling of the brain tissues and the presence of a hematoma within the brain put increasing pressure on the brain tissues and eventually destroys them. Bleeding may occur into the ventricles of the brain or into the subarachnoid space (the space between the brain and the membranes covering the brain), causing symptoms of meningeal irritation.

Symptoms vary depending on the extent of damage and the location of the bleed. Symptoms most commonly develop suddenly, without warning, often during activity. They may occasionally develop in a stepwise, episodic manner or in a progressive manner.