Lobar intracerebral hemorrhage

Disease	Injury	Nutrition	Poison

Special Topic	Surgery	Symptoms	Test

Arteries of the brain

Overview

Symptoms

Treatment

Prevention

Lobar intracerebral hemorrhage

Alternative Names:

Hemorrhage - intraparenchymal; Hemorrhage - intracerebral (lobar)

Symptoms:

Symptoms usually develop suddenly, without warning, often during activity. They vary, depending on the location of the bleed and the amount of brain tissue affected, and include the following:

Change in alertness (level of consciousness)*
- Apathetic, withdrawn
- Sleepy, lethargic, somnolent, stuporous
- Unconscious, comatose
- Presence of cerebral amyloid, causing dementia before the bleed occurs (rare in children)
Vomiting
- Occurs frequently
- Often described as occurring without nausea
- Occurs more frequently in the morning
Possible headache
- May develop suddenly
- May awaken the patient from sleep
- Increased with change in position
- Increased with bending, straining, coughing, etc.

*This is the first symptom in about 50% of people, including children

Symptoms of focal (localized) damage may develop:

Decreased vision (loss of all or part of vision)
Sensation changes
Difficulty speaking or understanding speech
Difficulty swallowing
Difficulty writing or reading
Movement changes
- Weakness of any body part
- Difficulty moving any body part
- Loss of fine motor skills/clumsiness
Loss of coordination
Loss of balance
Seizure

Other symptoms:

Stiff neck
Aching of neck, shoulders
Pain when bending neck

Additional symptoms that may be associated with this condition:

Signs and tests:

Neurological examination may indicate increased intracranial pressure, or focal neurologic deficits (decreases in brain function). The specific pattern of symptoms and function changes may indicate the location of the lobar intracerebral hemorrhage. Some patients with mild hemorrhages may only have a headache.

Findings on physical examination may include swelling of the optic nerve from increased pressure in the brain. There may be changes in eye movement, abnormal reflexes, decreased vision, loss of movement or coordination, or inability to feel sensations properly.

Tests to determine the amount and cause of bleeding may include:

Intracerebral hemorrhage may be confirmed, and the location and amount of bleeding determined by:

Head CT scan (preferred if bleed is less than 48 hours old)
Head MRI

Angiography of the head may be necessary in some cases to determine if there is aneurysm or arteriovenous malformation present.

Review Date: 7/31/2002
Reviewed By: Joseph V. Campellone, M.D., Division of Neurology, Cooper Hospital/University Medical Center, Camden, NJ. Review provided by VeriMed Healthcare Network.

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