Intracranial hemorrhage 851710 225818369 2008-07-15T15:27:48Z Delldot 476500 + info {{Infobox_Disease | Name = {{PAGENAME}} | Image = Intracerebral heamorrage 2.jpg | Caption = | DiseasesDB = 6870 | ICD10 = {{ICD10|I|60|0|i|60}}-{{ICD10|I|62||i|60}}, {{ICD10|S|06||s|00}} | ICD9 = {{ICD9|430}}-{{ICD9|432}}, {{ICD9|850}}-{{ICD9|854}} | ICDO = | OMIM = | MedlinePlus = 000796 | eMedicineSubj = neuro | eMedicineTopic = 177 | MeshID = D020300 | }} An '''intracranial hemorrhage''' is a [[hemorrhage]], or bleeding, within the [[skull]]. ==Causes== Intracranial bleeding occurs when a [[blood vessel]] in the head is ruptured or leaks. It can result from [[physical trauma]] (as occurs in [[head injury]]) or nontraumatic causes (as occurs in [[hemorrhagic stroke]]) such as a ruptured [[aneurysm]]. [[Anticoagulant]] therapy, as well as [[coagulopathy|disorders with blood clotting]] can heighten the risk that an intracranial hemorrhage will occur.<ref name="Kushner98"> {{ cite journal |author=Kushner D |title=Mild Traumatic Brain Injury: Toward Understanding Manifestations and Treatment |journal=Archives of Internal Medicine |volume=158 |issue=15 |pages=1617–1624 |year=1998 |pmid=9701095 |doi= |url=http://archinte.highwire.org/cgi/content/full/158/15/1617 }} </ref> ==Prognosis== Intracranial hemorrhage is a serious [[medical emergency]] because the buildup of [[blood]] within the skull can lead to increases in [[intracranial pressure]], which can crush delicate brain tissue or limit its blood supply. ==Diagnosis== CAT scan ([[computed axial tomography]]) is the definitive tool for accurate diagnosis of an intracranial hemorrhage. ==Classification== Types of intracranial hemorrhage are roughly grouped into intra-axial and extra-axial. The hemorrhage is considered a [[focal and diffuse brain injury|focal brain injury]]; that is, it occurs in a localized spot rather than causing diffuse damage over a wider area. ===Intra-axial hemorrhage=== Intra-axial hemorrhage is bleeding within the brain itself, or [[cerebral hemorrhage]]. This category includes: * [[Intraparenchymal hemorrhage]], or bleeding within the brain tissue. * [[Intraventricular hemorrhage]], bleeding within the brain's [[ventricular system|ventricle]]s (particularly of [[Premature birth|premature infants]]). ===Extra-axial hemorrhage=== Extra-axial hemorrhage, bleeding that occurs within the skull but outside of the brain tissue, falls into three subtypes: *[[Epidural hemorrhage]] which occur between the [[dura mater]] (the outermost [[meninx]]) and the skull, is caused by trauma. It may result from laceration of an artery, most commonly the [[middle meningeal artery]]. This is a very dangerous type of injury because the bleed is from a high-pressure system and deadly increases in [[intracranial pressure]] can result rapidly. **Patients have a loss of consciousness (LOC), then a [[lucid interval]], then sudden deterioration (vomiting, restlessness, LOC) **Head CT shows lenticular (convex) deformity. *[[Subdural hemorrhage]] results from tearing of the bridging veins in the [[subdural space]] between the [[dura mater|dura]] and [[arachnoid mater]]. **Head CT shows crescent-shaped deformity *[[Subarachnoid hemorrage]], which occur between the arachnoid and [[pia mater|pia]] meningeal layers, like intraparenchymal hemorrhage, can result either from trauma or from ruptures of [[aneurysm]]s or [[arteriovenous malformation]]s. Blood is seen layering into the brain along [[sulcus|sulci]] and [[fissure]]s, or filling [[Cistern (neuroanatomy)|cistern]]s (most often the [[suprasellar cistern]] because of the presence of the [[blood vessel|vessel]]s of the [[circle of Willis]] and their branchpoints within that space). The classic presentation of subarachnoid hemorrhage is the sudden onset of a severe headache (a [[thunderclap headache]]). This can be a very dangerous entity, and requires emergent neurosurgical evaluation, and sometimes urgent intervention. ==References== <references/> # 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. # 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. # 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 [[January 16]], [[2008]]. # Shepherd S. 2004. [http://www.emedicine.com/med/topic2820.htm "Head Trauma."] Emedicine.com. # Vinas FC and Pilitsis J. 2004. [http://www.emedicine.com/med/topic2888.htm "Penetrating Head Trauma."] Emedicine.com. ==External links== *[http://www.freehospital.org/free/hospital/DOCTOR:Intracranial_Haemorrhages DOCTOR:Intracranial_Haemorrhages] {{Vascular diseases}} {{Neurotrauma}} [[Category:Neurotrauma]] [[es:Hemorragia intracerebral]] [[zh:颅内出血]] [[he:דימום תוך-גולגולתי]]