Intracerebral haemorrhage

Causes include hypertension, neoplasm, vasculitis, coagulopathy and mycotic aneurysms associated with bacterial endocarditis.

Clinical features include sudden onset coma, drowsiness and/or neurological deficit. Headache usually occurs only with cortical and intraventricular haemorrhage. The rate of evolution depends on the size and size of the bleed. The area affected is the putamen (55%), thalamus (10%), cerebral cortex (15%), pons (10%) and cerebellum (10%).

Diagnosis

CT scan is the definitive test. A coagulation and vasculitis blood screen may be indicated. Angiography is indicated if surgical repair is contemplated though not for drainage of blood clot.

Treatment

• Supportive (e.g. hydration, nutrition, analgesia, ventilatory support)

• Physiotherapy

• Blood pressure control (maintain systolic BP <220-230 mmHg)

• Correct any coagulopathy

• Control raised intracranial pressure

• Surgery—contact Regional Centre, e.g. for evacuation of haematoma, repair/clipping of aneurysm

• Steroid therapy is ineffective

P.377

Was this article helpful?

0 0
Reducing Blood Pressure Naturally

Reducing Blood Pressure Naturally

Do You Suffer From High Blood Pressure? Do You Feel Like This Silent Killer Might Be Stalking You? Have you been diagnosed or pre-hypertension and hypertension? Then JOIN THE CROWD Nearly 1 in 3 adults in the United States suffer from High Blood Pressure and only 1 in 3 adults are actually aware that they have it.

Get My Free Ebook


Post a comment