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The incidence of intracerebral hemorrhage is estimated at 24.6 cases per 100,000 person years with the incidence rate being similar in men and women. [7] [8] The incidence is much higher in the elderly, especially those who are 85 or older, who are 9.6 times more likely to have an intracerebral hemorrhage as compared to those of middle age. [8]
Intracranial hemorrhage (ICH), also known as intracranial bleed, is bleeding within the skull. [1] Subtypes are intracerebral bleeds (intraventricular bleeds and intraparenchymal bleeds), subarachnoid bleeds, epidural bleeds, and subdural bleeds. [2] Intracerebral bleeding affects 2.5 per 10,000 people each year. [1]
Intraparenchymal hemorrhage is one form of intracerebral bleeding in which there is bleeding within brain parenchyma. The other form is intraventricular hemorrhage). [1] Intraparenchymal hemorrhage accounts for approximately 8-13% of all strokes and results from a wide spectrum of disorders.
The broad term, "stroke" can be divided into three categories: brain ischemia, subarachnoid hemorrhage and intracerebral hemorrhage. Brain ischemia can be further subdivided, by cause, into thrombotic, embolic, and hypoperfusion. [3] Thrombotic and embolic are generally focal or multifocal in nature while hypoperfusion affects the brain globally.
In more severe cases an external ventricular drain may be required to maintain ICP and evacuate the hemorrhage, and in extreme cases an open craniotomy may be required. [2] [14] In cases of unilateral IVH with small intraparenchymal hemorrhage the combined method of stereotaxy and open craniotomy has produced promising results. [15]
Subdural hygromas require two conditions in order to occur. First, there must be a separation in the layers of the Meninges of the brain. Second, the resulting subdural space that occurs from the separation of layers must remain uncompressed in order for CSF to accumulate in the subdural space, resulting in the hygroma. [1]
This category includes intraparenchymal hemorrhage, or bleeding within the brain tissue, and intraventricular hemorrhage, bleeding within the brain's ventricles (particularly of premature infants). Intra-axial hemorrhages are more dangerous and harder to treat than extra-axial bleeds. [10]
In serious cases, blood vessels rupture and cause bleeding within the brain (intracranial hemorrhage). [ a ] In more than half of patients with AVM, this is the first symptom. [ 7 ] Symptoms due to bleeding include loss of consciousness , sudden and severe headache, nausea, vomiting , incontinence , and blurred vision , amongst others. [ 4 ]