Intraparenchymal hemorrhage

Abstract

Intracerebral hemorrhage is a spontaneous extravasation of blood into the brain parenchyma. It represents 10-15 % of all clinical strokes in the Western world and is associated with a higher mortality rate compared to ischemic stroke and subarachnoid hemorrhage. It is classified as primary or secondary according to its etiologies. More than one-half of primary bleeds are related to hypertension and one-third are associated with cerebral amyloid angiopathy. Secondary hemorrhages are due to drugs, vascular malformations, coagulopathy, neoplasms, trauma, vasculitis, moyamoya disease, and sinus venous thrombosis. An abrupt onset of focal neurological symptoms is presumed to be vascular in origin until proven otherwise; however, it is impossible to know whether symptoms are caused by ischemia or hemorrhage on the basis of clinical characteristics alone, and thus neuroimaging is needed to ascertain their cause.