Intracerebral hemorrhage

Alternative names:

hemorrhage - intracerebral; intracranial hemorrhage; thalamic hemorrhage

Symptoms:

• headache
  • may occur when flat, and awaken person 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  • apathetic, withdrawn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

• vision changes
  • any change in vision
  • decreased vision, loss of all or part of vision
  • eyes, pupils different size
  • eye movements, uncontrollable
  • eye lid drooping

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

• difficulty speaking or understanding speech
• difficulty swallowing
• difficulty writing or reading
• movement changes
  • weakness of any body part
  • difficulty moving any body part
  • loss of fine motor skills
  • hand tremor

• loss of coordination
• loss of balance
• seizure/spell
• abnormal taste
• abnormal lack of sweating

Signs and tests:

Neuromuscular examination may indicate increased intracranial pressure or focal neurologic deficits (decreases in brain function). The specific pattern of symptoms and function changes may indicate the location of the intracerebral hemorrhage. Eye examination may show optic nerve swelling from increased pressure in 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.

Tests to determine the amount and cause of bleeding may include:

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

Intracerebral hemorrhage may be confirmed, and the location and amount of bleeding determined by these tests:

• head CT scan ( preferred if the bleed is less than 48 hours old)
• head MRI
• angiography of the head (if symptoms allow enough time) to determine if there is an aneurysm or arteriovenous malformation present