What is an intracerebral hemorrhage (ICH)?
An intracerebral hemorrhage usually occurs when an artery ruptures in the brain area. The arteries are responsible for transporting blood to areas of the brain. An increase in blood pressure is on of the most common causes of a ruptured artery. Blood is released from the point where the artery ruptures and forms into a clot. This clot is known as a hematoma. As the hematoma increases in size, it puts pressure on the brain tissues. Toxins are also formed as the blood cells which form the hematoma die. A stroke may also occur as a part of the brain connected to the ruptured artery is unable to receive the blood which provides oxygen.
Symptoms of intracerebral hemorrhage include the loss of balance, dizziness, nausea, and vomiting, problems with vision in one or both eyes, a problem with reading, speech, and writing as well as understanding spoken words. A patient with intracerebral hemorrhage may also experience weakness, confusion, and paralysis in the face which may extend down to the arms and legs. Paralysis indicating intracerebral hemorrhage frequently occurs on one side of the body.
About this Condition
Intracerebral hemorrhage is a type of stroke which can lead to life-threatening situations. If the brain does not get the required amount of oxygen and blood, this will result in a stroke. If an artery is put under pressure, this can cause it to burst. As a result of blood leaking from this artery, the area which it supplies does not receive enough blood. This then leads to a stroke.
There are various causes of intracerebral hemorrhage. It may be as a result of an aneurysm which causes a weakening of arterial walls. Bleeding disorders such as sickle cell anemia, thrombocytopenia, and hemophilia may also lead to intracerebral hemorrhage. Some of the more common causes include a penetrating wound which damages the skull and use of drugs such as cocaine. Hypertension, trauma, and tumors may also lead to intracerebral hemorrhage.
What treatments are available?
Treatment for intracerebral hemorrhage may be either medical treatment or surgical treatment. Although the damages caused may be permanent, treatment is usually done to put a stop to the bleeding, remove the clot formed as a result of the bleeding and reduce the pressure on the brain tissue.
Medical treatment is advised in a situation where there is a small hemorrhage. A patient who is experiencing a cerebellar hemorrhage, large lobar hemorrhage or hydrocephalus is treated by performing surgery. The surgery is done to eliminate the hematoma formed as a result of the blood leak in the brain.
As a method of reducing the possibility of a large quantity of blood leaking out of the damaged artery, the blood pressure has to be controlled in such a way that the flow of blood is still adequate to supply the brain.
An ICP monitor is a device which is used to measure the pressure within the brain. This is done by placing it inside the ventricles. It is important and plays a vital role in the regulation of intracranial pressure. A pressure reading of 20mmHg is the standard reading for the intracranial pressure.
The intracranial pressure is regulated by draining some of the cerebrospinal fluid present in the ventricles. This is done using a shunt inserted into the ventricle. Draining some of the cerebrospinal fluid helps to create space for the expansion of the hematoma. As a result of this extra space, the hematoma can expand without damaging any part of the brain. Regulation of intracranial pressure can also be achieved with the use of drugs to induce coma and also by Hyperventilation.
Through surgical treatment it is possible to stop the source of the bleeding and also eliminate a significant portion of the clot formed in the brain. There are two major surgeries which are used in treating this condition, and the surgical operation is chosen based on where the clot is formed.
A craniotomy is a procedure which involves the use of a drill to make a hole in the skull wide enough to see the brain and also eliminate the hematoma. In most cases where this surgery is performed, the hematoma is usually present close to the brain surface. This is because the operation comes with a lot of risk to the brain.
This surgical procedure involves the use of a stereotactic frame. A metal cage is then attached to this frame. After identifying the exact location of the hematoma through a scan, a hole is drilled in the skull. A needle is then inserted into the hole to the site of the clot. This needle is attached to a syringe. When the needle pierces into the clot, the liquid present is extracted by the syringe. This procedure is used in the case of a hematoma which is not close to the surface of the brain.