Presentation
Traumatic MMA aneurysms usually present with extradural hematomas, whereas intradural intraparenchymal hematomas are exceedingly rare. [ncbi.nlm.nih.gov]
Entire Body System
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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]
Medications also may be given to reduce blood pressure and to treat multiple symptoms of the hemorrhage, including headache, fever, and seizure. [upmc.com]
A vast majority of patients with ICH have fever during the postictal period and the incidence is higher in those with intraventricular hemorrhage. The duration of fever correlates inversely with the patient outcome. [intechopen.com]
Fever control Fever is common after ICH, particularly in patients with intraventricular extension. [svn.bmj.com]
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Acutely Ill Patient
Thus, the medical guidelines below are based on the reported experience of treatment of ICH in clinical series as well as general guidelines for treatment of any acutely ill patient in a neuro-intensive care unit. [ispub.com]
Thus, the medical guidelines below are based on the reported experience of treatment of ICH in clinical series as well as general guidelines for treatment of any acutely ill patient in a neuro–intensive care unit. [stroke.ahajournals.org]
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Pseudotumor
Lumboperitoneal shunting is widely used for the surgical management of pseudotumor cerebri and other pathologies such as communicating hydrocephalus. [ncbi.nlm.nih.gov]
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Hodgkin Lymphoma
A 6-year-old male with the diagnosis of non-Hodgkin lymphoma was put on a treatment regimen, including intrathecal methotrexate. [ncbi.nlm.nih.gov]
Gastrointestinal
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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]
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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]
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]
Cardiovascular
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Hypertension
[…] invasive liquefaction and drainage of intracerebral hematoma in the treatment of hypertensive putamen hemorrhage. [ncbi.nlm.nih.gov]
Eyes
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Pupillary Abnormality
abnormalities (present in 30-50%) Papilledema Asymmetric reflexes Babinski sign Aphasia or dysphasia Gait abnormalities Neck stiffness etc. [faculty.washington.edu]
Initial emergency intracranial pressure management Emergency measures for ICP control are appropriate for stuporous or comatose patients, or those who present acutely with clinical signs of brain stem herniation (that is, pupillary abnormalities or motor [ccforum.biomedcentral.com]
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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]
Urogenital
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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]
Neurologic
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Headache
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]
Abstract A 69-year-old woman presented with headache and short memory disturbance. Computed tomography (CT) demonstrated a small cystic mass lesion in the left temporal lobe. [jstage.jst.go.jp]
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Seizure
Three normotensive patients presented with seizures and CT showed an intracerebral hematoma. [ncbi.nlm.nih.gov]
Her seizures began at age 41 years and were of the partial-complex type, with alteration of consciousness and motor automatisms. Seizures were controlled with phenytoin sodium, phenobarbital, and primidone. [jamanetwork.com]
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Confusion
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]
"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]
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Stupor
In the worst case, the drowsiness gives way to stupor as signs of upper brainstem compression appear. [enotes.tripod.com]
[…] 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]
[…] tingling, weakness, numbness, paralysis, severe headache, difficulty with swallowing or vision, loss of balance or coordination, difficulty understanding, speaking, reading, or writing, and a change in level of consciousness or alertness, marked by stupor [my.clevelandclinic.org]
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]
According to Juvela et al, 1989 [40] the mortality of semicomatose or stuporous patients was lower in surgical group than in conservative group but all surviving patients in this subgroup were severely disabled, while in the study of Batjer et al, 1998 [middleeastmedicalportal.com]
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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]
Such possible symptoms include:[2] Difficulties with movement coordination, including muscle weakness and even paralysis; Vertigo (dizziness); Difficulties of speech (dysarthria) and communication, such as aphasia; Difficulties with everyday activities [en.wikipedia.org]
Workup
However, CTA is not available in many institutions, and a large proportion of ICH patients do not receive a CTA as part of their diagnostic workup 1. This highlights the need for novel markers of hematoma growth that do not require a CTA. [journals.heart.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]
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]
In TICH only group, the factors affecting prognosis were initial GCS score, pupillary reflex, amount of hematoma and DTICH. [jkns.or.kr]
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]
Aims: To explore etiology of ICH and correlate the causes, location, and size of hemorrhage to clinical outcome. [dx.doi.org]
Epidemiology
Epidemiology, risk factors, and clinical features of intracerebral hemorrhage: An update. J Stroke, 19:3–10. [6] Boulouis G, van Etten ES, Charidimou A, Auriel E, Morotti A, Pasi M, et al (2016). [aginganddisease.org]
The etiology, epidemiology, treatment and prognosis vary widely depending on the type of hemorrhage, and as such these are discussed separately. [radiopaedia.org]
The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. Int J Surg 2014; 12: 1495–1499. Google Scholar Crossref Medline ISI 19. Rankin, J. [journals.sagepub.com]
There is racial variation in the incidence of bleeding into the brain substance; Asians, Latin American, Mexican American, Native American and African American patients have a greater risk according to epidemiological data. [minneapolisclinic.com]
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]
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]
Conclusion The overrepresentation of cerebellar ICH location and intraventricular extension in OAC-ICH might have mechanistic relevance for the underlying arteriopathy, pathophysiology, or bleeding pattern of OAC-ICH, and should be investigated further [n.neurology.org]
These are dramatic, debilitating, and often fatal events, but does the pathophysiology of intracranial hemorrhage extend beyond that of mass effect? Blood contains several factors that are potentially, and in some cases definitively, neurotoxic. [ahajournals.org]
Prevention
It may be prevented in the future by improved thrombolytic drugs. [ncbi.nlm.nih.gov]
Hematoma expansion (HE) is a further marker of poor prognosis that may be at least partly preventable. Several risk factors for HE have been identified, including baseline ICH volume, anticoagulation, and computed tomography angiography spot signs. [experts.umn.edu]
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]
Primary prevention by controlling hypertension should be a goal of national healthcare programs. [intechopen.com]