Neurol. praxi. 2017;18(2):94-97 | DOI: 10.36290/neu.2017.071

Intracerebral hemorrhage

MUDr. Martin Šrámek

Komplexní cerebrovaskulární centrum, Ústřední vojenská nemocnice – Vojenská fakultní nemocnice, Praha

Neurologická klinika 2. LF UK a FN Motol, Praha

Intraparenchymal hemorrhage (ICH) accounts for 10–20 % of all strokes, its mortality is much higher compared to ischemic

strokes. 55 % of hematomas are localised deeply in brain hemisphere, 30 % in lobes and 15 % in the brain stem. The most frequent

causes of ICH are hypertensive vasculopathy, amyloid angiopathy, vessel malformation or tumors. ICH patients should

be admited to an ICU, the goal of therapy is blood pressure normalisation using intravenous drugs, coagulopathy treatment in

patients on anticoagulation therapy and cerebral edema treatment. Prophylactic antiseizure medication is not recommended.

Surgical treatment is effective in cerebellar or superficial hemorrhages. Anticoagulation after ICH is possible in carefully selected

patients, an alternative approach in atrial fibrilation patients is left appendage closure.

Keywords: intraparenchymal hemorrhage, hypertension, edema, coagulopathy, anticoagulation

Published: May 1, 2017  Show citation