Hypertensive intracerebral hemorrhage

Alternative names:

hemorrhage - intracerebral (hypertensive)

Symptoms:

• rapid loss of function(s) on one side of the body
• vision changes
  • any change in vision
  • decreased vision

• sensation changes
  • numbness, tingling
  • decreased sensation
  • abnormal sensations

• movement changes
  • weakness of any body part
  • difficulty moving any body part
  • loss of fine motor skills

• difficulty speaking
• difficulty swallowing
• difficulty reading or writing
• loss of coordination
• loss of balance
• seizure or spell
• headache
  • when lying flat
  • may awaken from sleep
  • increases with change in position, bending, straining, coughing

• nausea, vomiting
• decreased consciousness
  • apathetic, withdrawn
  • sleepy, lethargic, somnolent, stuporous
  • unconscious, comatose

Signs and tests:

Neuromuscular examination may indicate increased intracerebral pressure and localized decreases in brain function. The specific pattern of function changes may indicate the location of the intracerebral hemorrhage. Eye examination may show swelling of the optic nerve associated with increased pressure within the brain, or there may be changes in eye movement. Abnormal reflexes may be present, or there may be an abnormal extent of normal reflexes. The blood pressure is usually high.

Tests to determine the amount and cause of bleeding include:

• CBC
• platelet count
• bleeding time
• prothrombin time
• partial thromboplastin time
• liver function tests
• kidney function tests
• angiography of the head (if symptoms allow enough time to perform this test) reveals any aneurysm or arteriovenous malformation present

Intracerebral hemorrhage can be confirmed, and the location and amount of bleeding determined, by:

• head CT scan (preferred if the hemorrhage began less than 48 hours ago)
• head MRI