Intracerebral Haemorrhage (ICH) is a life-threatening condition with a high rate of morbidity and fatality. The fourth in a series on stroke from Missouri medicine outlines the clinical and imaging components of ICH diagnosis. Current medicinal and surgical treatments are described, as well as outcome predictors and secondary prevention measures. Epidural hematoma, subdural hematoma, Subarachnoid Haemorrhage (SAH), Intraventricular Haemorrhage (IVH), Hemorrhagic Transformation of ischemic stroke (HT), venous haemorrhage from cortical vein or sinus thrombosis, and intracerebral haemorrhage are all examples of intracranial haemorrhage. The primary topic of this, the fourth in a six-part Missouri Medicine Stroke series, is Intracerebral Haemorrhage (ICH), which includes Intraventricular Haemorrhage for the sake of this discussion (IVH). Subarachnoid Haemorrhage is more discussed in (SAH).

Intracerebral haemorrhage is responsible for 10%-15% of all strokes and is associated with extremely high morbidity and fatality rates that have remained constant over the previous 30 years. Death rates range from 51% to 65% after a year, depending on the site of the haemorrhage. The first two days account for half of all deaths. Only 20% of patients are predicted to be self-sufficient after six months. Hemorrhage is more common in men than in women and increases exponentially with age. The main presenting hallmark of ICH is a sudden onset of localized neurological impairment that worsens over minutes to hours. The location of the initial bleeding and subsequent edoema is reflected in the nature of the impairments. Seizures, vomiting, headaches, and a loss of consciousness are all frequent side effects. In acute ischemic strokes, both headache and a reduced degree of consciousness are uncommon.

With Regards,
Sara Giselle
Associate Managing Editor
Journal of Stroke Research & Therapy