Merck Manual

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Intracerebral Hemorrhage


The Manual's Editorial Staff

Last full review/revision Oct 2019| Content last modified Oct 2019
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What is an intracerebral hemorrhage?

"Intra" means within. The cerebrum is your brain. Hemorrhage is bleeding. So intracerebral hemorrhage is bleeding inside your brain. An intracerebral hemorrhage is a medical emergency that often causes permanent brain damage or death. Intracerebral hemorrhage caused by anything other than injury is considered a type of stroke.

  • An intracerebral hemorrhage happens when a blood vessel bursts in your brain

  • The usual cause is high blood pressure

  • The first symptom is usually a headache

  • You may become confused or go into a coma

  • Doctors will treat the problems that caused your bleeding, such as high blood pressure

People who have any symptom of an intracerebral hemorrhage should go to an emergency department immediately.

What causes an intracerebral hemorrhage?

An intracerebral hemorrhage is caused by a blood vessel bursting in your brain.

The most common cause of a bursting blood vessel is high blood pressure, which weakens your blood vessels.

Less common causes are:

  • Using cocaine or amphetamines (uppers)

  • Being born with abnormal blood vessels in your brain

  • Severe head injury

  • Brain tumor

  • Using too much blood thinning medicine

What are the symptoms of an intracerebral hemorrhage?

Symptoms of an intracerebral hemorrhage start suddenly. You usually get a very bad headache, often while being active. Older people may not have a headache or only a mild one. Other common symptoms are:

  • Weakness or numbness on one side of your body

  • Trouble speaking

  • Confusion

  • Feeling sick to your stomach or throwing up

  • Seizures

  • Passing out

An intracerebral hemorrhage is so serious that about half of people who have it die in the first few days. Most survivors have long-lasting brain damage.

How will my doctor know if I had an intracerebral hemorrhage?

Doctors usually suspect an intracerebral hemorrhage based on your symptoms. To make sure they're right, they'll get detailed pictures of the inside of your brain with an imaging test (CT scan or MRI).

How do doctors treat an intracerebral hemorrhage?

Doctors will admit you to the hospital and treat the problems that caused your bleeding. They'll have you stay in bed and stop taking any medicines that could make your bleeding worse. You also may get:

  • Medicine to relieve your headache and any seizures you may have

  • Medicine and fluids to keep your blood pressure at the right level

  • If you were taking blood thinners, you may get medicine to help your blood clot and stop the bleeding

  • Sometimes, surgery to remove the extra blood and relieve pressure within the skull

NOTE: This is the Consumer Version. DOCTORS: Click here for the Professional Version
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