Deep intracerebral hemorrhage

Alternative names:

hemorrhage - intracerebral (deep)

Symptoms:

• headache
  • may occur when lying flat, may cause patient to awaken from sleep
  • may increase with change in position
  • may increase with bending, straining, and coughing

• nausea, vomiting
• change in alertness (level of consciousness)
  • apathetic, withdrawn
  • sleepy, lethargic, somnolent, stuporous
  • unconscious, comatose

• decreased vision
• loss of all or part of vision
• sensation changes, usually on only one side of the body
  • decreased sensation
  • numbness, tingling
  • abnormal sensations

• difficulty speaking or understanding speech
• difficulty swallowing
• difficulty writing or reading
• movement changes, usually on only one side of the body
  • weakness of any body part
  • difficulty moving any body part
  • loss of fine motor skills

• loss of coordination
• loss of balance
• seizure

Additional symptoms that may be associated with this disease:

• loss of muscle function or feeling loss
• movement, dysfunctional
• facial paralysis
• eye lid drooping

Note: Symptoms vary depending on the location of the bleed and the amount of brain tissue affected. Symptoms most commonly develop suddenly, without warning, often during activity. They may be episodic or develop in a progressively worsening manner in some cases.

Signs and tests:

Neuromuscular examination may indicate increased intracranial pressure or decreases in specific brain functions. The specific pattern of symptoms and function changes may indicate which of the deep brain tissues are affected. For example, sudden nausea, vomiting, loss of balance, headache, and rapid decrease in consciousness may indicate a bleed in the cerebellum. Eye examination may show swelling of the optic nerve from pressure in the brain, or there may be changes in eye movement. Abnormal reflexes may be present, or there may be abnormal levels of normal reflexes.

Tests to determine the amount and cause of bleeding include:

• CBC
• platelet count
• bleeding time
• prothrombin or partial thromboplastin time (PT/PTT)
• liver function tests
• kidney function tests

Deep intracerebral hemorrhage may be confirmed, and the exact location and amount of bleeding determined by:

• head CT (may be preferred if bleed is less than 48 hours old)
• MRI of head