Spontaneous Intracerebral Hemorrhage

Abstract

Intracerebral hemorrhage (ICH) represents cerebral parenchymal bleeding that may also extend into ventricular, and rarely, subarachnoid space. As a stroke subtype, it is associated with poor neurological outcome as well as high mortality. The worldwide incidence of ICH ranges from 10 to 20 cases per 100,000 population and increases with age. Different risk factors can cause ICH: hypertension (the main and the most common risk factor), cerebral amyloid angiopathy, previous use of anticoagulant therapy, excessive use of alcohol, and also other risk factors such as serum cholesterol levels and some genetic factors. Its clinical presentation usually consist of a decreased level of consciousness with headache and vomiting (in patients with a large hematoma), and depending on localization some specific neurological signs could be present: contralateral sensory-motor deficits of varying severity, aphasia, neglect, gaze deviation, hemianopsia, abnormalities of gaze, cranial-nerve abnormalities, as well as ataxia, nystagmus, and dysmetria.Emergency diagnosis and management in neurological intensive care, or stroke units, with hypertension treatment, administration of haemostatic agents and general therapeutic measures for critically ill neurological patients may positively influence the outcome. Nevertheless, a larger number of randomized controlled studies are needed to answer several important questions, including how to treat hypertension, which haemostatic agent to use, as well as determining place and time of surgical treatment. LJILJANA BESLA]-BUMBA[IREVI] VI[NJA PA\EN DEJANA R. JOVANOVI] MAJA STEFANOVI]-BUDIMKI]

Enhancing Rehabilitative Therapies with Vagus Nerve Stimulation

“…Intracerebral hemorrhage (ICH) is a devastating subtype of stroke, affecting as many as 52,000 people each year in the USA [70]. ICH has a mechanistically distinct pathophysiology from ischemic stroke, characterized by bleeding in the brain parenchyma, which often damages cortical and subcortical structures [70].…”

“…ICH has a mechanistically distinct pathophysiology from ischemic stroke, characterized by bleeding in the brain parenchyma, which often damages cortical and subcortical structures [70]. A recent global epidemiological study indicates that the disability adjusted life years lost to ICH is nearly double that lost to ischemic stroke, highlighting the significant burden of this disease [71].…”

Inflammation after Intracerebral Hemorrhage

“…Depending on the underlying cause of bleeding, ICH is classified as either primary (unrelated to congenital or acquired lesions) or secondary (directly related to congenital or acquired lesions). Primary ICH accounts for 78% to 88% of cases and originates from the spontaneous rupture of small arteries or arterioles damaged by two major causes: hypertensive arteriolosclerosis and amyloid angiopathy (reviewed in Mayer and Rincon, 2005;Qureshi et al, 2001b;Sutherland and Auer, 2006). Secondary ICH occurs in a minority of patients in association with coagulopathy, brain tumors, aneurysms, vascular anomalies, and thrombolytic treatment of ischemic stroke (Mayer and Rincon, 2005;Qureshi et al, 2001b;Sutherland and Auer, 2006;Wang and Tsirka, 2005a).…”

Neurogenesis after Primary Intracerebral Hemorrhage in Adult Human Brain

“…Management of patients with ICH is generally limited to supportive care or evacuation of the hematoma, although the efficacy of surgical removal is variable and controversial (Broderick et al, 1999;Heiskanen, 1993;Qureshi et al, 2001).…”