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Intracerebral Hematoma


Presentation

  • The diagnostic problems that this type of vascular malformation presents and its role in the development of the encapsulated hematoma are discussed.[ncbi.nlm.nih.gov]
  • The authors report a case of intracerebral hematoma, which has never been reported as a presenting symptom of cerebral sparganosis.[ncbi.nlm.nih.gov]
  • Abstract We present a young patient with myocardial infarction who had recurrent coronary thrombosis, in-stent thrombosis, and a major pulmonary arterial thromboembolism due to primary antiphospholipid syndrome.[ncbi.nlm.nih.gov]
  • The mechanisms of hematoma expansion and the management strategy in such a case are discussed, and a review of the pertinent literature is presented.[ncbi.nlm.nih.gov]
  • Traumatic MMA aneurysms usually present with extradural hematomas, whereas intradural intraparenchymal hematomas are exceedingly rare.[ncbi.nlm.nih.gov]
Fever
  • He was admitted to our emergency department with complaints of fever and confusion. Physical, neurological, and laboratory examinations and cranial computed tomography identified vitamin K deficiency and intracerebral hematoma.[ncbi.nlm.nih.gov]
  • , purulent discharge from any wounds), aspiration pneumonia (shortness of breath, pulmonary congestion, fever, productive cough), increased ICP Response to medications used to control pain and increased ICP Discharge and home healthcare guidelines Be[medical-dictionary.thefreedictionary.com]
  • Induced normothermia was initiated during this period, with reductions in water temperature used as a surrogate for fever. During this period, a mild elevation in INR (1.5) was corrected with transfusion of fresh frozen plasma.[thoracic.org]
  • […] fatigue problems with swallowing vision loss difficulty with sensations or movements on one side of the body pneumonia cognitive dysfunction (memory loss, difficulty reasoning), confusion swelling on the brain seizures depression, emotional problems fever[healthline.com]
  • Fevers are common in this patient population. The patient should be investigated for infection, and the fever should be treated with antipyretic medication and/or cooling devices to maintain normothermia and minimize secondary brain injury.[cancertherapyadvisor.com]
Vomiting
  • […] volume of brain contents and ICP disrupts blood flow casuing the brain to become ischemic and hypoxic closed or open head injury or from a cerebraovascular condition (GSW, Deep depressed fractures, CVA, ruptured cerebral aneurysm) signs of IICP - HA, vomiting[quizlet.com]
  • […] brain and lead to symptoms such as: Sudden weakness, tingling or paralysis in the face, arm or leg, especially on only one side of the body Sudden severe headache Trouble with vision in one or both eyes Trouble with language skills Confusion Nausea and vomiting[columbianeurosurgery.org]
  • They include: headache difficulty speaking nausea vomiting decreased consciousness weakness in one part of the body elevated blood pressure Most ICHs are due to a head injury.[healthline.com]
  • SX: headache & vomiting are hallmarks of acute hemorrhages. Seizures are uncommon but occur in a few instances.[enotes.tripod.com]
  • In infants: irritability, vomiting, bulging anterior fontanelle Can result in brain herniation and death CT findings: hyperdensity from the hematoma, usually concave towards the brain ("crescent"-shaped) and crossing suture lines, in contrast to epidural[faculty.washington.edu]
Nausea
  • These are often related to vision although may also include other symptoms such as nausea, dizziness or pins and needles.[sportsinjuryclinic.net]
  • […] of the brain and lead to symptoms such as: Sudden weakness, tingling or paralysis in the face, arm or leg, especially on only one side of the body Sudden severe headache Trouble with vision in one or both eyes Trouble with language skills Confusion Nausea[columbianeurosurgery.org]
  • Nausea, vomiting, delirium, and focal or generalized seizures are also common. Neurologic deficits are usually sudden and progressive.[msdmanuals.com]
  • Physical examination The most common symptoms are alterations in level of consciousness, headache, nausea, and vomiting . Seizures and focal neurological deficits may occur.[medical-dictionary.thefreedictionary.com]
  • Symptoms of subdural hematoma can include: Headache Confusion Change in behavior Dizziness Nausea and vomiting Lethargy or excessive drowsiness Weakness Apathy Seizures People may vary widely in their symptoms of subdural hematoma.[webmd.com]
Hypertension
  • […] invasive liquefaction and drainage of intracerebral hematoma in the treatment of hypertensive putamen hemorrhage.[ncbi.nlm.nih.gov]
  • METHODS: Six patients with hypertensive basal ganglia hematoma underwent stereotactic aspiration of hematoma with a frameless and fiducial-free navigation system during January 2007 to April 2007.[ncbi.nlm.nih.gov]
  • None of the patients had identifiable coagulopathy, and only 1 patient was hypertensive in the immediate postoperative period.[ncbi.nlm.nih.gov]
  • A 55-year-old woman presented with sudden loss of consciousness without a past history of hypertension.[ncbi.nlm.nih.gov]
  • When initial audible bruit in traumatic CCF disappears suddenly, cerebral angiography should be performed to differentiate venous hypertension by the hemodynamic changes of the cavernous sinus channels from spontaneous resolution of CCF.[ncbi.nlm.nih.gov]
Purpura
  • […] here a case of extremely severe CA-MSSA aortic valve acute endocarditis associated with persistent Staphylococcus aureus bacteremia (SAB) in a previously healthy man and include a literature review.The patient developed severe and rare complications (purpura[ncbi.nlm.nih.gov]
Blurred Vision
  • We report the case of a 53-year-old man presenting with a headache of sudden onset and blurred vision secondary to hemorrhage from a nonfunctioning pituitary adenoma, which had been treated 25 years previously by transcranial surgery and postoperative[ncbi.nlm.nih.gov]
  • A 44-year-old female applied to our clinic with complaints of severe headache, retroorbital pain and blurred vision. Lumbar puncture demonstrated cerebrospinal fluid opening pressure of cmH2O.[ncbi.nlm.nih.gov]
  • Seek immediate medical attention after a blow to the head if you: Lose consciousness Have a persistent headache Have difficulties such as vomiting, weakness, blurred vision, unsteadiness If signs and symptoms aren't immediately evident after a blow to[mayoclinic.org]
Pupillary Abnormality
  • abnormalities (present in 30-50%) Papilledema Asymmetric reflexes Babinski sign Aphasia or dysphasia Gait abnormalities Neck stiffness etc.[faculty.washington.edu]
Retroorbital Pain
  • A 44-year-old female applied to our clinic with complaints of severe headache, retroorbital pain and blurred vision. Lumbar puncture demonstrated cerebrospinal fluid opening pressure of cmH2O.[ncbi.nlm.nih.gov]
Urinary Incontinence
  • Case Presentation This is a 21-year-old right-handed male, with a past medical history significant for asthma and Attention Deficit Disorder (ADD), treated with methylphenidate, who was found in a gym bathroom with left sided weakness and urinary incontinence[thoracic.org]
Headache
  • The presenting symptoms include headache, seizures and focal neurological deficit, which are due to a parasitic granulomatous space-occupying lesion.[ncbi.nlm.nih.gov]
  • We report the case of a 53-year-old man presenting with a headache of sudden onset and blurred vision secondary to hemorrhage from a nonfunctioning pituitary adenoma, which had been treated 25 years previously by transcranial surgery and postoperative[ncbi.nlm.nih.gov]
  • We report a 57-year-old man who presented one month after sustaining a traumatic right temporal intracerebral hematoma with history of headache, left hemiparesis and altered sensorium of two days duration.[ncbi.nlm.nih.gov]
  • A 44-year-old female applied to our clinic with complaints of severe headache, retroorbital pain and blurred vision. Lumbar puncture demonstrated cerebrospinal fluid opening pressure of cmH2O.[ncbi.nlm.nih.gov]
  • Headaches are an extremely common complaint. They vary in pain intensity, pattern and location from individual to individual. Although irritating the majority of headaches do not require medical intervention.[sportsinjuryclinic.net]
Seizure
  • Three normotensive patients presented with seizures and CT showed an intracerebral hematoma.[ncbi.nlm.nih.gov]
  • The presenting symptoms include headache, seizures and focal neurological deficit, which are due to a parasitic granulomatous space-occupying lesion.[ncbi.nlm.nih.gov]
  • Chronic expanding intracerebral hematoma (CEIH) is a rare cerebrovascular disease that behaves as a slowly expanding lesion with a gradual onset of progressive neurological deficit or recurrent seizures. The etiology of the CEIH is still not clear.[ncbi.nlm.nih.gov]
  • A 62-year-old man was referred with a 2-month history of generalized tonicoclonic seizures. There was no history of head injury or arterial hypertension. The results of a neurological examination were normal.[ncbi.nlm.nih.gov]
  • Eight patients were comatose on admission, three had focal seizures, and three had focal findings.[ncbi.nlm.nih.gov]
Confusion
  • This 56-year-old man presented with postoperative confusion. The cause is local injury.[ncbi.nlm.nih.gov]
  • He was admitted to our emergency department with complaints of fever and confusion. Physical, neurological, and laboratory examinations and cranial computed tomography identified vitamin K deficiency and intracerebral hematoma.[ncbi.nlm.nih.gov]
  • He remained confused and restless for 2 days, but then showed progressive recovery in the consciousness level as well as motor and verbal functions. Shengmai-yin contains herbal ingredients that can interact with warfarin.[ncbi.nlm.nih.gov]
  • "short of breath," "can't walk or stand," "confused and febrile"). A special feature of this section is the use of algorithms and decision trees in triage - to help the physician make a very fast and yet informed decision.[books.google.es]
  • […] surrounding areas of the brain and lead to symptoms such as: Sudden weakness, tingling or paralysis in the face, arm or leg, especially on only one side of the body Sudden severe headache Trouble with vision in one or both eyes Trouble with language skills Confusion[columbianeurosurgery.org]
Dysarthria
  • His family history disclosed that his brother had a similar episode of dysarthria.[thejournalofheadacheandpain.springeropen.com]
  • Dysarthria & dysphagia may occur. There are no Babinski signs until late in the evolution of the hemorrhage as it expands to the brainstem.[enotes.tripod.com]
  • He had fluent speech with a mild dysarthria and left facial droop. His sensation was intact and motor strength were intact except for persistent right sided weakness.[thoracic.org]
  • ヤーコブ病 d deep sensation深部感(知)覚 deep tendon reflex深部腱反射 deliriumせん(譫)妄、うわごと delusion妄想 dementia痴呆 dendrite 樹状突起 difficulty in swallowing嚥下困難 doll's eye phenomenon人形の目現象 dopamineドーパミン dorsal root後根 double vision複視 drop foot下垂足(垂れ足)、尖足 drop hand[下]垂手(垂れ手) dysarthria[tokyo-med.ac.jp]
  • Vomiting, dizziness, occipital-occasionally in one side of the head, frontal or associated with neck and shoulder pain mimicking SAH and headache are very frequent symptoms while, dysarthria, tinnitus, and hiccups are less frequent.[ispub.com]
Stupor
  • […] and coma, coma 1 hour with mcc 083 Traumatic stupor and coma, coma 1 hour with cc 084 Traumatic stupor and coma, coma 1 hour without cc/mcc 085 Traumatic stupor and coma, coma 086 Traumatic stupor and coma, coma 087 Traumatic stupor and coma, coma 955[icd10data.com]
  • In the worst case, the drowsiness gives way to stupor as signs of upper brainstem compression appear.[enotes.tripod.com]
  • Symptoms can include: Abnormal sense of taste Change in alertness (level of consciousness) Apathetic, withdrawn Sleepy, lethargic, stuporous Unconscious, comatose Difficulty speaking or understanding speech Difficulty swallowing Difficulty writing or[snc.md]
  • Other Medical Management Issues Many patients who are delirious or stuporous are agitated. Hyperactivity is distressing to patients, caregivers, and family and may lead to self-injury.[ispub.com]

Workup

Staphylococcus Aureus
  • BACKGROUND: Over the last decades Staphylococcus aureus (SA) has become the dominant etiology of native valve infective endocarditis, with the community-acquired methicillin-sensible Staphylococcus aureus (CA-MSSA) strains being the prevailing type.[ncbi.nlm.nih.gov]
  • Empiric antibiotic coverage was initiated with vancomycin and doripenem, and de-escalated within 48 hrs to vancomycin alone when sputum culture grew Methicillin-Resistant Staphylococcus Aureus (MRSA), and overall clinical improvement (defervescence and[thoracic.org]

Treatment

  • CONCLUSION: Clinical observation and following-up results revealed that minimally invasive drainage treatment was superior to internal medical treatment and craniotomy.[ncbi.nlm.nih.gov]
  • […] on surgical treatment have been reported.[ncbi.nlm.nih.gov]
  • Treatment within 6 hours of SAH was associated with poorer outcome than treatment thereafter (adjusted OR 1.67; 95% CI 1.04-2.69).[ncbi.nlm.nih.gov]
  • , and early treatment may lead to better results.[ncbi.nlm.nih.gov]
  • The treatment decision (coil, clip, or hematoma evacuation) was based on an interdisciplinary approach.[ncbi.nlm.nih.gov]

Prognosis

  • BACKGROUND: Subarachnoid hemorrhage (SAH) with an intracerebral hematoma (ICH) shows an unfavorable prognosis. In the present study, we examined the characteristics of SAH with ICH and its prognosis.[ncbi.nlm.nih.gov]
  • However, little is reported about the comparison on the efficacy of various approaches on the prognosis.[ncbi.nlm.nih.gov]
  • The prognosis after evacuation of a chronic subdural hematoma is generally good, yet occasionally post-operative complications do occur. Intracerebral hematoma following such evacuation is rare and two cases are reported.[ncbi.nlm.nih.gov]
  • In TICH only group, the factors affecting prognosis were initial GCS score, pupillary reflex, amount of hematoma and DTICH.[jkns.or.kr]
  • Therefore, we believe that endoscopic hematoma evacuation with our surgical procedure is a promising ultra-early stage treatment for intracerebral hemorrhage and that it may improve the long-term prognosis in patents with intracerebral hemorrhage.[ncbi.nlm.nih.gov]

Etiology

  • Rupture of one or several of the distended venous channels from increased back-flow is postulated as the etiology of the intraparenchymal hematomas.[ncbi.nlm.nih.gov]
  • The etiology of the chronic expanding intracerebral hematomas was not delineated in these 3 patients.[ncbi.nlm.nih.gov]
  • BACKGROUND: Over the last decades Staphylococcus aureus (SA) has become the dominant etiology of native valve infective endocarditis, with the community-acquired methicillin-sensible Staphylococcus aureus (CA-MSSA) strains being the prevailing type.[ncbi.nlm.nih.gov]
  • The etiology of the CEIH is still not clear. Even if about a half of these lesions are associated with vascular malformations, the remaining cases are post-traumatic, associated with coagulative disorders or are cryptogenic.[ncbi.nlm.nih.gov]
  • Aims: To explore etiology of ICH and correlate the causes, location, and size of hemorrhage to clinical outcome.[dx.doi.org]

Epidemiology

  • The etiology, epidemiology, treatment and prognosis vary widely depending on the type of hemorrhage, and as such these are discussed separately.[radiopaedia.org]
  • Pradilla, Emory University, USA 21st May, 2019 Tuesday 11:56-12:11 Dissecting sulci to access ICH: Minimally invasive surgery, the EnrICH Trial and BrainPath device Adnan Qureshi, University of Missouri, USA 19th May, 2019 Sunday 15:05-15:20 The changing epidemiological[worldich.org]
  • Epidemiology ICH: occurs in 12-30 per 100,000 people each year in the United States, accounts for 10% of all strokes, with a mortality rate of 30-50%. SAH accounts for 5% of all strokes. It affects 30,000 individuals per year in the United States.[cancertherapyadvisor.com]
  • There is insufficient epidemiological evidence to conclude whether recent alcohol use affects risk of either ischemic or hemorrhagic stroke12. Serum cholesterol level below the 10th percentile (sex-specific 14.[ispub.com]
Sex distribution
Age distribution

Pathophysiology

  • Abstract Recent investigations have indicated the importance of secondary brain damage in the pathophysiology of intracerebral hemorrhage (ICH), which includes ischemic brain damage and edema formation around a hematoma.[ncbi.nlm.nih.gov]
  • However, there is optimism that the management of spontaneous supratentorial intracerebral haemorrhage will change in future based new insight and better understanding of the acute pathophysiology of hematomas and its dynamics.[ncbi.nlm.nih.gov]
  • In two nonhypertensive patients, intracerebral hematomas secondary to a ruptured berry aneurysm and an arteriovenous malformation contained high levels of radioisotopic activity, suggesting a different pathophysiology of bleeding.[jamanetwork.com]
  • Introduction to Pathophysiology in the front matter section provides intro to the subject of pathophysiology and explains why it is important.[books.google.it]
  • This book describes the pathoanatomical, pathophysiological, and imaging features of vascular malformations and aneurysms of the brain and the modern, minimally invasive endovascular methods or techniques employed in their treatment.[books.google.it]

Prevention

  • It may be prevented in the future by improved thrombolytic drugs.[ncbi.nlm.nih.gov]
  • Expansion of the initial hematoma is a further marker of poor prognosis that may be at least partly preventable.[ncbi.nlm.nih.gov]
  • Further analysis to study whether blood glucose control prevents hematoma expansion is warranted. Disclosure: Dr. Kubiak has nothing to disclose. Dr. Mohamed has nothing to disclose. Dr. Bhattacharya has nothing to disclose.[n.neurology.org]
  • He’s also the Director of Columbia’s Cerebrovascular Research Laboratory , where he is at the forefront of the work being done to find better ways to both treat and prevent hematomas and other such neurological emergencies in the brain—to get blood back[columbianeurosurgery.org]
  • When turning the patient, prevent Valsalva’s maneuver by using a draw sheet to pull the patient up in bed. Instruct the patient not to hold on to the side rails.[medical-dictionary.thefreedictionary.com]

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