Presentation
Traumatic MMA aneurysms usually present with extradural hematomas, whereas intradural intraparenchymal hematomas are exceedingly rare. [ncbi.nlm.nih.gov]
Entire Body System
- Fever
He was admitted to our emergency department with complaints of fever and confusion. Physical, neurological, and laboratory examinations and cranial computed tomography identified vitamin K deficiency and intracerebral hematoma. [ncbi.nlm.nih.gov]
Medications also may be given to reduce blood pressure and to treat multiple symptoms of the hemorrhage, including headache, fever, and seizure. [upmc.com]
On postoperative day 1, the patient developed septic shock with fever of 103.6 °F, fluid refractory hypotension, oliguria, increasing serum lactate and leukocytosis. [thoracic.org]
It manifests with other symptoms such as fever, stiffness, and nausea. There’s redness in one eye. You have a history of cancer or a weakened immune system. The headache wakes you up and you can’t fall asleep again. [exploringyourmind.com]
Fever control Fever is common after ICH, particularly in patients with intraventricular extension. [svn.bmj.com]
- Acutely Ill Patient
Thus, the medical guidelines below are based on the reported experience of treatment of ICH in clinical series as well as general guidelines for treatment of any acutely ill patient in a neuro-intensive care unit. [ispub.com]
Thus, the medical guidelines below are based on the reported experience of treatment of ICH in clinical series as well as general guidelines for treatment of any acutely ill patient in a neuro–intensive care unit. [stroke.ahajournals.org]
Gastrointestinal
- Vomiting
They include: headache difficulty speaking nausea vomiting decreased consciousness weakness in one part of the body elevated blood pressure Most ICHs are due to a head injury. [healthline.com]
[…] volume of brain contents and ICP disrupts blood flow casuing the brain to become ischemic and hypoxic closed or open head injury or from a cerebraovascular condition (GSW, Deep depressed fractures, CVA, ruptured cerebral aneurysm) signs of IICP - HA, vomiting [quizlet.com]
In infants: irritability, vomiting, bulging anterior fontanelle Can result in brain herniation and death CT findings: hyperdensity from the hematoma, usually concave towards the brain ("crescent"-shaped) and crossing suture lines, in contrast to epidural [faculty.washington.edu]
SX: headache & vomiting are hallmarks of acute hemorrhages. Seizures are uncommon but occur in a few instances. [enotes.tripod.com]
Nausea, vomiting, delirium, and focal or generalized seizures are also common. Neurologic deficits are usually sudden and progressive. [msdmanuals.com]
- Nausea
Nausea, vomiting, delirium, and focal or generalized seizures are also common. Neurologic deficits are usually sudden and progressive. [msdmanuals.com]
These are often related to vision although may also include other symptoms such as nausea, dizziness or pins and needles. [sportsinjuryclinic.net]
[…] of the brain and lead to symptoms such as: Sudden weakness, tingling or paralysis in the face, arm or leg, especially on only one side of the body Sudden severe headache Trouble with vision in one or both eyes Trouble with language skills Confusion Nausea [columbianeurosurgery.org]
It manifests with other symptoms such as fever, stiffness, and nausea. There’s redness in one eye. You have a history of cancer or a weakened immune system. The headache wakes you up and you can’t fall asleep again. [exploringyourmind.com]
Cardiovascular
- Hypertension
[…] invasive liquefaction and drainage of intracerebral hematoma in the treatment of hypertensive putamen hemorrhage. [ncbi.nlm.nih.gov]
Lamichhane D, Paudel R: Multiple simultaneous hypertensive supratentorial and infratentorial hemorrhages: a rare kind of hypertensive bleed. J Coll Med Sci Nepal 2010;6:53-56. [karger.com]
They were not considered surgical candidates because even having hypertensive basal ganglia hematomas they presented one of exclusion items described below. [scielo.br]
Skin
- Flushing
Physicians or nurses may have to adjust or flush these small diameter catheters to manage medical tube obstructions and occlusions at the intensive-care bedside.[8] Migration After EVD placement, the drain is tunneled subcutaneously and secured with surgical [en.wikipedia.org]
Eyes
- Pupillary Abnormality
abnormalities (present in 30-50%) Papilledema Asymmetric reflexes Babinski sign Aphasia or dysphasia Gait abnormalities Neck stiffness etc. [faculty.washington.edu]
Initial emergency intracranial pressure management Emergency measures for ICP control are appropriate for stuporous or comatose patients, or those who present acutely with clinical signs of brain stem herniation (that is, pupillary abnormalities or motor [ccforum.biomedcentral.com]
Urogenital
- Urinary Incontinence
Case Presentation This is a 21-year-old right-handed male, with a past medical history significant for asthma and Attention Deficit Disorder (ADD), treated with methylphenidate, who was found in a gym bathroom with left sided weakness and urinary incontinence [thoracic.org]
Neurologic
- Headache
Headaches are an extremely common complaint. They vary in pain intensity, pattern and location from individual to individual. Although irritating the majority of headaches do not require medical intervention. [sportsinjuryclinic.net]
We report a 57-year-old man who presented one month after sustaining a traumatic right temporal intracerebral hematoma with history of headache, left hemiparesis and altered sensorium of two days duration. [ncbi.nlm.nih.gov]
Abstract A 69-year-old woman presented with headache and short memory disturbance. Computed tomography (CT) demonstrated a small cystic mass lesion in the left temporal lobe. [jstage.jst.go.jp]
- Seizure
Three normotensive patients presented with seizures and CT showed an intracerebral hematoma. [ncbi.nlm.nih.gov]
Her seizures began at age 41 years and were of the partial-complex type, with alteration of consciousness and motor automatisms. Seizures were controlled with phenytoin sodium, phenobarbital, and primidone. [jamanetwork.com]
- Confusion
He was admitted to our emergency department with complaints of fever and confusion. Physical, neurological, and laboratory examinations and cranial computed tomography identified vitamin K deficiency and intracerebral hematoma. [ncbi.nlm.nih.gov]
Deterioration in consciousness, including increasing confusion, sleepiness, and a deep coma, can quickly follow. [msdmanuals.com]
"short of breath," "can't walk or stand," "confused and febrile"). A special feature of this section is the use of algorithms and decision trees in triage - to help the physician make a very fast and yet informed decision. [books.google.es]
- Dizziness
These are often related to vision although may also include other symptoms such as nausea, dizziness or pins and needles. [sportsinjuryclinic.net]
However, with time, pressure on your brain increases, producing some or all of the following signs and symptoms: Increasing headache Vomiting Drowsiness and progressive loss of consciousness Dizziness Confusion Unequal pupil size Slurred speech As more [mayoclinic.org]
Symptoms of subdural hematoma can include: Headache Confusion Change in behavior Dizziness Nausea and vomiting Lethargy or excessive drowsiness Weakness Apathy Seizures People may vary widely in their symptoms of subdural hematoma. [webmd.com]
[…] anticoagulants to reduce clotting antiseizure medications medications to counteract any blood thinners that you’ve been taking An ICH can lead to any of the following complications: seizures paralysis headaches brain development problems in children memory loss dizziness [healthline.com]
- Stupor
[…] and coma, coma >1 hour with mcc 083 Traumatic stupor and coma, coma >1 hour with cc 084 Traumatic stupor and coma, coma >1 hour without cc/mcc 085 Traumatic stupor and coma, coma 086 Traumatic stupor and coma, coma 087 Traumatic stupor and coma, coma [icd10data.com]
In the worst case, the drowsiness gives way to stupor as signs of upper brainstem compression appear. [enotes.tripod.com]
[…] tingling, weakness, numbness, paralysis, severe headache, difficulty with swallowing or vision, loss of balance or coordination, difficulty understanding, speaking, reading, or writing, and a change in level of consciousness or alertness, marked by stupor [my.clevelandclinic.org]
Symptoms can include: Abnormal sense of taste Change in alertness (level of consciousness) Apathetic, withdrawn Sleepy, lethargic, stuporous Unconscious, comatose Difficulty speaking or understanding speech Difficulty swallowing Difficulty writing or [snc.md]
According to Juvela et al, 1989 [40] the mortality of semicomatose or stuporous patients was lower in surgical group than in conservative group but all surviving patients in this subgroup were severely disabled, while in the study of Batjer et al, 1998 [middleeastmedicalportal.com]
Workup
However, CTA is not available in many institutions, and a large proportion of ICH patients do not receive a CTA as part of their diagnostic workup 1. This highlights the need for novel markers of hematoma growth that do not require a CTA. [journals.heart.org]
Treatment
CONCLUSION: Clinical observation and following-up results revealed that minimally invasive drainage treatment was superior to internal medical treatment and craniotomy. [ncbi.nlm.nih.gov]
Prognosis
BACKGROUND: Subarachnoid hemorrhage (SAH) with an intracerebral hematoma (ICH) shows an unfavorable prognosis. In the present study, we examined the characteristics of SAH with ICH and its prognosis. [ncbi.nlm.nih.gov]
The volume of hematoma significantly influenced six-month prognosis (survival and functional dependency) in patients with ICH. [hindawi.com]
The island sign correlated with poor prognosis as well. [journals.heart.org]
Etiology
Rupture of one or several of the distended venous channels from increased back-flow is postulated as the etiology of the intraparenchymal hematomas. [ncbi.nlm.nih.gov]
The etiology, epidemiology, treatment and prognosis vary widely depending on the type of hemorrhage, and as such these are discussed separately. [radiopaedia.org]
Epidemiology
The etiology, epidemiology, treatment and prognosis vary widely depending on the type of hemorrhage, and as such these are discussed separately. [radiopaedia.org]
There is racial variation in the incidence of bleeding into the brain substance; Asians, Latin American, Mexican American, Native American and African American patients have a greater risk according to epidemiological data. [minneapolisclinic.com]
Epidemiology, risk factors, and clinical features of intracerebral hemorrhage: An update. J Stroke, 19:3–10. [6] Boulouis G, van Etten ES, Charidimou A, Auriel E, Morotti A, Pasi M, et al (2016). [aginganddisease.org]
We provide an outline for epidemiologic features of MSICHs as well as for clinical outcome. [karger.com]
Pathophysiology
Abstract Recent investigations have indicated the importance of secondary brain damage in the pathophysiology of intracerebral hemorrhage (ICH), which includes ischemic brain damage and edema formation around a hematoma. [ncbi.nlm.nih.gov]
Introduction to Pathophysiology in the front matter section provides intro to the subject of pathophysiology and explains why it is important. [books.google.it]
In two nonhypertensive patients, intracerebral hematomas secondary to a ruptured berry aneurysm and an arteriovenous malformation contained high levels of radioisotopic activity, suggesting a different pathophysiology of bleeding. [jamanetwork.com]
Prevention
Expansion of the initial hematoma is a further marker of poor prognosis that may be at least partly preventable. [ncbi.nlm.nih.gov]
Prevention To prevent or minimize head injury: Wear a helmet and make sure your kids wear helmets. [mayoclinic.org]
Hematoma expansion (HE) is a further marker of poor prognosis that may be at least partly preventable. Several risk factors for HE have been identified, including baseline ICH volume, anticoagulation, and computed tomography angiography spot signs. [experts.umn.edu]
Primary Prevention (to prevent a first stroke) Primary prevention is when antiplatelet drugs are taken before a stroke or a TIA has occurred. [mountsinai.org]