Intracerebral hemorrhage

Intracranial hemorrhage; Hemorrhage - intracerebral; Hypertensive hemorrhage

• Headache
  • May occur when lying flat
  • May awaken patient from sleep
  • May increase with change in position
  • May increase with bending, straining, and coughing
• Nausea, vomiting
• Change in alertness (level of consciousness)
  • Apathetic, withdrawn
  • Sleepy, lethargic, somnolent, stuporous
  • Unconscious, comatose
• Vision changes
  • Any change in vision
  • Decreased vision, loss of all or part of vision
  • Pupils different size
  • Uncontrollable eye movements
  • Eyelid drooping
• Sensation changes
  • Decreased sensation
  • Numbness or tingling
  • Abnormal sensations
  • Facial paralysis
• Difficulty speaking or understanding speech
• Difficulty swallowing
• Difficulty writing or reading
• Movement changes
  • Weakness of any body part
  • Difficulty moving any body part
  • Loss of fine motor skills
  • Hand tremor
• Loss of coordination
• Loss of balance
• Seizure
• Abnormal sense of taste

A neurological exam may suggest increased intracranial pressure or decreased brain functions. The person's specific symptoms can help tell which part of the brain is affected.

An eye exam may show swelling of the optic nerve from increased pressure in the brain. There may be changes in eye movement, abnormal reflexes, decreased vision, loss of movement or coordination, or inability to feel sensations properly.

Tests may include:

• CBC
• Platelet count
• Bleeding time
• Prothrombin time (PT) or partial thromboplastin time (PTT)
• Liver function tests
• Kidney function tests
• Head CT scan
• Head MRI or MRA
• Cerebral angiography or spiral CT scan angiography of the head to look for an aneurysm or arteriovenous malformation