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Hemorrhagic Stroke

more about Hemorrhagic Stroke


Intracerebral hemorrhage or stroke

  • The cerebral hemisphere of our bicameral (two-chambered) brain is known as the seat of thought, memory, awareness, motor function, sensory function, and speech -- i.e., the higher brain. When a hemorrhage (bleeding from traumatic injury or arterial damage) occurs inside the brain in one or both of the hemispheres, it is called an Intracerebral Hemorrhage.
  • Hypertension (High Blood Pressure) is one of the prime causes. It is also suspected that the underlying blood vessels of the brain may be abnormal with microaneurysms (i.e., tiny outpouchings of the arterial walls which are weak and subject to bursting).
  • Bleeding commonly occurs in the basal ganglia, and less commonly in the pons, thalamus, cerebellum, and cerebral white matter. The hemorrhage (bleeding) may extend into the ventricular system or subarachnoid space of the brain. The bleeding, in some cases, may compress the brain stem (lower part of the brain). If brain stem compression occurs, the death rate is very high.

  • Loss of consciousness (in 50%)
  • Vomiting
  • Headache
  • Paralysis, Speech Problems, or other specific neurological problems, depending on the area of the bleed


  • Examination:
    1. Eye gaze palsies (inability to move the eyeball) may be present
    2. Pupils may not be equal
    3. Paralysis may be present
  • Imaging:
    1. CT scan of brain (without contrast)
    2. Cerebral Angiography (dye injected and X-Rays taken) to rule out an aneurysm
  • Laboratory:

- Complete blood count, platelets, Prothrombin time (PT), partial thromboplastin time (PTT), bleeding times, kidney function (BUN and Creatinine), and liver function tests

  • Lumbar puncture (spinal tap) should not be done because it may cause brain herniation.

  • Supportive
  • Treat underlying Bleeding Disorders
  • Surgical decompression if a hematoma (blood clot) puts pressure on the brain

  • This is a life-threatening emergency and needs immediate emergency medical treatment.




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