Cerebral hemorrhage 2959528 225822140 2008-07-15T15:48:16Z Delldot 476500 merging info from [[intraparenchymal hemorrhage]], cleanup, rewording. Per concerns on [[Talk:Intraparenchymal hemorrhage]] {{Infobox_Disease | Name = {{PAGENAME}} | Image = Intracerebral heamorrage 2.jpg | Caption = Intracerebral hemorrhage | DiseasesDB = | ICD10 = {{ICD10|I|61||i|60}} | ICD9 = {{ICD9|431}} | ICDO = | OMIM = | MedlinePlus = | eMedicineSubj = | eMedicineTopic = | MeshID = D002543 | }} '''Cerebral hemorrhage''' (or '''intracerebral hemorrhage'''), is a subtype of [[intracranial hemorrhage]] that occur within the [[brain]] tissue itself. Intracerebral hemorrhage can be caused by [[brain trauma]], or it can occur spontaneously in [[hemorrhagic stroke]]. Cerebral hemorrhage is '''intra-axial hemorrhage'''; that is, it occurs within the brain tissue rather than outside of it. The other category of intracranial hemorrhage is extra-axial hemorrhage, such as [[epidural hematoma|epidural]], [[subdural hematoma|subdural]], and [[subarachnoid hematoma]]s, which all occur within the skull but outside of the brain tissue. There are two main kinds of intra-axial hemorrhages: '''intraparenchymal hemorrhage''' and [[intraventricular hemorrhages]]. As with other types of hemorrhages within the skull, intraparenchymal bleeds are a serious [[medical emergency]] because they can increase [[intracranial pressure]]. The mortality rate for intraparenchymal bleeds is over 40%.<ref name="Sanders and McKenna">Sanders MJ and McKenna K. 2001. Mosby’s Paramedic Textbook, 2nd revised Ed. Chapter 22, "Head and Facial Trauma." Mosby.</ref> ==Causes== More common in adults than in children, intraparenchymal bleeds are usually due to [[penetrating head trauma]], but can also be due to depressed [[skull fracture]]s, [[acceleration-deceleration trauma]],<ref name="McCaffrey">McCaffrey P. 2001. [http://www.csuchico.edu/~pmccaff/syllabi/SPPA336/336unit11.html "The Neuroscience on the Web Series: CMSD 336 Neuropathologies of Language and Cognition."] California State University, Chico. Retrieved on [[June 19]], [[2007]].</ref><ref name="Orlando Regional Healthcare">Orlando Regional Healthcare, Education and Development. 2004. [http://www.orlandoregional.org/pdf%20folder/overview%20adult%20brain%20injury.pdf "Overview of Adult Traumatic Brain Injuries."] Retrieved on [[2008-01-16]].</ref><ref name="Shepherd">Shepherd S. 2004. [http://www.emedicine.com/med/topic2820.htm "Head Trauma."] Emedicine.com. Retrieved on [[June 19]], [[2007]].</ref> rupture of an [[aneurysm]] or [[arteriovenous malformation]] (AVM), and bleeding within a [[tumor]]. A very small proportion is due to [[cerebral venous sinus thrombosis]]. ==Prognosis== The risk of death from an intraparenchymal bleed is especially high when the injury occurs in the [[brain stem]].<ref name="Sanders and McKenna"/> Intraparenchymal bleeds within the [[medulla]] are almost always fatal, because they cause damage to cranial nerve X, the [[vagus nerve]], which plays an important role in [[blood circulation]] and breathing.<ref name="McCaffrey"/> This kind of hemorrhage can also occur in the [[Cerebral cortex|cortex]] or subcortical areas, usually in the [[frontal lobe|frontal]] or [[temporal lobe]]s when due to head injury, and sometimes in the [[cerebellum]].<ref name="McCaffrey"/><ref name="Graham and Gennareli ">Graham DI and Gennareli TA. Chapter 5, "Pathology of Brain Damage After Head Injury" Cooper P and Golfinos G. 2000. ''Head Injury'', 4th Ed. Morgan Hill, New York.</ref> ==Symptoms== Patients with intraparenchymal bleeds have symptoms that correspond to the functions controlled by the area of the brain that is damaged by the bleed.<ref name="Vinas and Pilistis">Vinas FC and Pilitsis J. 2006. [http://www.emedicine.com/med/topic2888.htm "Penetrating Head Trauma."] Emedicine.com.</ref> Other symptoms include those that indicate a rise in [[intracranial pressure]] due to a large mass putting pressure on the brain.<ref name="Vinas and Pilistis"/> ==Diagnosis== Intraparenchymal hemorrhage can be recognized on [[CT scan]]s because blood appears brighter than other tissue and is separated from the inner table of the skull by brain tissue. The tissue surrounding a bleed is often less dense than the rest of the brain due to edema, and therefore shows up lighter on the CT scan. ==References== {{Reflist|2}} ==External links== * [http://www.aboutkidshealth.ca/PrematureBabies/Intraventricular-Hemorrhage-IVH.aspx?articleID=7511&categoryID=PI-nh1-07c Parent friendly information on IVH in premature babies from The Hospital for Sick Children] * [http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/neuro/ivh.html LPCH on Intraventricular] {{Vascular diseases}} {{Neurotrauma}} [[Category:Neurotrauma]] {{Link FA|he}} [[de:Intracerebrale Blutung]] [[nl:Intracerebraal hematoom]] [[ja:脳内出血]] [[he:דימום תוך-גולגולתי]]