Definition

An intracerebral hemorrhage (ICH) is bleeding in the brain. It is a type of stroke that can be deadly.

Causes

ICH is caused by a burst blood vessel in the brain. The most common causes are:

• High blood pressure
• Cerebral amyloid angiopathy—a buildup of a protein on the walls of the arteries in the brain

Other causes may be:

• Head trauma
• Abnormal blood vessels in the brain, such as cerebral aneurysms and arteriovenous malformations
• Bleeding disorders
• Medicine used to treat bleeding disorders
• Tumors
• Drug use, such as cocaine

Risk Factors

Older adults are at higher risk. It is also more common in men and people who are Black, Hispanic, Asian, and Native American. A family history of stroke also raises the risk.

Other things that may raise the risk are:

• Having certain health problems, such as high blood pressure, bleeding disorders, or diabetes
• Having abnormal blood vessels
• Taking blood thinning medicine
• Smoking
• Using drugs, such as cocaine
• Alcohol use disorder

Symptoms

Symptoms depend on the size and location of the ICH. A person may have:

• Sudden weakness or numbness of the face, arm, or leg, often on one side
• Sudden confusion
• Problems speaking
• Problems seeing in one or both eyes
• Loss of consciousness
• Nausea and vomiting
• Sudden severe headache
• Seizures

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done.

Blood tests and urine tests will be done.

Images will be taken of your brain. This can be done with:

• CT scan
• MRI scan

Treatment

Brain tissue can die without blood. Emergency care will be needed right away. It may include:

Prevention

These things can help lower the risk of getting ICH:

• Stop or limit alcohol. This means no more than 1 drink per day for women and no more than 2 drinks per day for men.
• Reach and stay at a healthy weight.
• Manage high blood pressure.
• Take steps to stop smoking.