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Hypertensive intracerebral hemorrhage

  • Treatment

    Surgery may be needed to remove the hematoma, especially if there is a hematoma in the base of the brain (cerebellum). If bleeding blocks the flow of spinal fluid, a shunt or drain in the brain may be recommended in some cases.

    Medications include:

    • Anti-hypertensive medications to control blood pressure
    • Corticosteroids such as hydrocortisone and diuretics to drain fluid from the body to reduce brain swelling
    • Anti-convulsants to control seizures
    • Analgesics to control pain

    If the patient gets quick medical attention, anti-bleeding therapy may be appropriate. This involves using a medicine that stops the bleeding. It is very important that this type of medicine be given within 3 hours of the symptoms first starting, so it is important to get to the hospital quickly. Such therapy is still being studied, and there are strict guidelines regarding who should and should not get such medication. There is a risk of significant side effects with anti-bleeding therapy.

    Most patients will be admitted to a hospital's intensive care unit (ICU) for close monitoring.


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    Expectations (prognosis)

    How well a person does depends on the size and location of the bleed. Recovery can occur completely, or there may be some level of permanent loss of brain function.

    Medications, surgery, and other treatments can have severe side effects. Death can occur rapidly despite prompt medical attention.


    Complications
    • Permanent loss of any brain function
    • Seizures
    • Side effects of medications and treatments
    • Complications of surgery

    Calling your health care provider

    Intracerebral hemorrhage is a life-threatening condition requiring immediate emergency medical attention.

    Go to the emergency room or call the local emergency number (such as 911) if symptoms of hypertensive intracerebral hemorrhage occur. Emergency symptoms include difficulty breathing, seizures, loss of consciousness, inability to speak and swallowing difficulties, numbness or clumsiness on one side of the body, slurred speech, or confusion.