Synonyms
- ICB
- Intracerebral hematoma
- Intracerebral hemorrhage
- Intracerebral hemorrhage
- Cerebral hemorrhage
Definition
Spontaneous intracerebral hemorrhage (ICB) is a bleeding into the brain tissue (parenchyma) that is not caused by trauma. Intracerebral haemorrhages (cerebral haemorrhage) can be classified according to cause (medical etiology) and severity, as well as according to their localization in the brain tissue.
Generic term Circulatory disorders of the brain, classification
In cerebral circulatory disorders, which are the most common cause of acute neurological deficits, a distinction is made between cerebral ischemia, i.e. reduced supply to the brain, which at 85% is far more common among circulatory disorders of the brain than vascular (vascular) cerebral haemorrhages (15%). A detached blood clot (embolus), which settles in the brain vessels, inflammatory changes in the vessels (vasculitis) or plaque deposits (arteriosclerosis) from the larger blood vessels can cause vessels to become constricted or blocked and the following section is thus not sufficiently supplied with oxygen and nutrients (ischemia). This leads to the death of the tissue.
In the brain, this is particularly dangerous because on the one hand, important functions such as movement processes or memory performance fail and on the other hand, the nerve cells cannot be reproduced, so that permanent damage can occur. In the second group of cerebral circulatory disorders, a distinction is made between ICB and subarachnoid hemorrhage, i.e. acute bleeding in the space filled with cerebrospinal fluid (liquor) between the meninges surrounding the brain. In contrast to cerebral hemorrhage, which will be discussed in more detail below, subarachnoid hemorrhage is caused by an accident (medical trauma) or a rupture of a pre-existing cerebral vessel dilatation (aneurysm rupture).
What are the typical symptoms of a cerebral hemorrhage?
Cerebral hemorrhages are potentially life-threatening conditions that can occur for a variety of reasons. They differ not only in their causes, but also in their symptoms. Depending on the type of cerebral haemorrhage, different symptoms characteristic of cerebral haemorrhage can be observed.
The symptoms of an intracerebral hemorrhage usually occur suddenly and differ depending on the location and size of the hemorrhage. The range of symptoms is wide, from symptomless, small microbleedings to mass bleedings with a quick death. The possible symptoms are often similar to those of a stroke.
These include impaired speech, hemiplegia and impaired vision. A turn of gaze to the side of the bleeding is also typical. Furthermore, nausea and vomiting, as well as gait and standing difficulties may occur.
Headaches and – in the early phase of bleeding – epileptic seizures are also typical symptoms. Extensive bleeding can also lead to severe disturbances of consciousness and coma. Epidural bleeding, which usually affects young people after an accident, for example during sports, leads to a very typical symptomatology.
Initially, a brief unconsciousness usually occurs. However, those affected usually regain consciousness quickly and then show no symptoms. In the course of the disease, however, the pressure in the brain increases due to the bleeding, resulting in nausea, vomiting, agitation and headaches.
A renewed impairment of consciousness with unconsciousness is typical. Hemiplegia can also occur. Subdural bleeding can have both an acute symptomatic and a chronic course.
Acute subdural bleeding is indistinguishable from epidural bleeding because of its symptoms and also leads to symptoms such as headaches, nausea, vomiting and loss of consciousness. Chronic bleeding tends to develop gradual symptoms and manifests itself as a general slowdown and memory impairment. Chronic subdural bleeding is therefore often easily overlooked, especially in older people.
The dreaded bleeding caused by an aneurysm is also known as subarachnoid hemorrhage. Only in about 15% of cases subarachnoid hemorrhage also occurs due to trauma, for example an accident. Quite typical for such a bleeding is the destruction headache, which owes its name to the intensity of the pain.
Affected individuals describe this type of headache as a pain such as they have never had before. It spreads over the entire head and can extend to the neck and back. It can also cause vomiting, nausea and sweating.
In some cases there is little or no loss of consciousness.Sometimes, however, those affected immediately collapse unconscious. Various paralyses, speech disorders and neurological deficits are possible with such a bleeding. Epileptic seizures can also occur.
