Deep intracerebral hemorrhage

Alternative names:

hemorrhage - intracerebral (deep)

Definition:

A condition where there is bleeding within the deep structures of the brain (thalamus, basal ganglia, pons, cerebellum).

Causes, incidence, and risk factors:

Intracerebral hemorrhage occurs in about 2 out of 1,000 people. It can affect any person regardless of age, sex, or race. Bleeding can occur in any part of the brain, and blood may accumulate in the tissues or in the space between the brain and the membranes covering the brain (subarachnoid space). It may be isolated to part of one cerebral hemisphere (lobar intracerebral hemorrhage) or may occur in other brain structures such as the thalamus, basal ganglia, pons, or cerebellum (deep intracerebral hemorrhage). Of the deep structures, intracerebral hemorrhage that is not caused by trauma most commonly occurs in the basal ganglia.

Intracerebral hemorrhage may be caused by head injury (trauma) or abnormalities of the blood vessels (cerebral aneurysm or angioma--tumors involving the blood vessels). When it is not caused by one of these conditions, it is most commonly associated with high blood pressure (hypertensive intracerebral hemorrhage). In some cases, no cause can be found.

Bleeding in the brain irritates the brain tissues causing swelling (cerebral edema). It may collect into a mass (hematoma). Both cerebral edema and the presence of a hematoma within the brain will place increasing pressure on the brain tissues and eventually destroy them. Symptoms will vary depending on the extent of damage and the location of the bleed.

Risks for intracerebral hemorrhage, in addition to the causative disorders, includes various blood or bleeding disorders (disseminated intravascular coagulation (DIC), hemophilia, sickle cell anemia, leukemia, decreased blood platelets), use of aspirin or anticoagulant medications (blood thinners), liver disease (which is associated with increased bleeding risk), and cerebral amyloid or other brain tumors.