Maraguinot, Erelson C.

BSN – 4

Intracerebral Hemorrhage

Intracerebral haemorrhage (ICH) is a common and serious disease. About 1 to 2 out of

10 patients with stroke have an ICH. The mortality of ICH is higher than that of ischemic
stroke. Only 31% are functionally independent at 3 months. Only 38% of the patients
survive the 1st year. The cost of ICH is high. Hypertension is the major risk factor,
increasing the risk of ICH about 4x. Up to half of hypertensive patients who suffer a ICH
are either unaware of their hypertension, non-compliant with the medication or fail to
control periodically their blood pressure levels Microbleeds and white matter changes
are MRI markers of the risk of ICH. ICH has 3 main pathophysiological phases: arterial
rupture and haematoma formation, haematoma enlargement and peri-haematoma
oedema. Up to 40% of the haematomas grow in the first hours post-rupture. ICH growth
is associated with early clinical deterioration. Two randomised clinical trials (RCTs)
demonstrated that treatment with rFVIIa limited haematoma growth and improved
outcome, but was associated with a increase in thromboembolic complications.
Ventricular drainage with thrombolytics might improve outcome for patients with
intraventricular bleeding. A large RCT and meta-analysis failed to show a benefit of
surgery over conservative treatment in acute ICH.

Reaction:

There are many causes of intracerebral hemorrhage, but the major signs and
symptoms is hypertension. The explanation above is more on the manifestations that
the patient will have, internally. 40% is up to develop different kinds of hematoma, a
large number that will awaken our minds on safety precaution to our life. percentage
shown that pathology of intracerebral hemorrhage is very fast to disseminate other parts
of the body that cause decreasing resistance to compensate body’s defense
mechanism.