Intracerebral Hemorrhage
This type of stroke happens when a blood vessel is broken and there is bleeding into the tissue deep within the brain. High blood pressure is often the cause of this type of stroke. It can also be related to a weakened blood vessel. The ruptured vessel stops blood supply for the areas past the leak. Blood then floods the nearby tissues causing pressure and changes in function. It is referred to as a hemorrhagic (hem-o-RAJ-ic) stroke. Subarachnoid hemorrhage is another form of bleeding stroke. This is not the type you experienced.
What are the effects of intracerebral hemorrhage?
An intracerebral hemorrhage may appear and progress very quickly. It can happen anytime of day, many times while active. This is a serious type of stroke and may lead to coma and death.
Other changes that may be a result of an intracerebral hemorrhage include:
• Physical changes
o weakness on one side of the body
o lack of awareness of one side of the body
o difficulty speaking clearly
o knowing what you want to say but not being able to say it
o difficulty understanding
o difficulty swallowing
• Mental changes may include problems with:
o memory
o judgment
o problem solving
o learning
o attention
• Emotional effects:
o behavior and personality changes (the person may act different than their “normal self”)
o depression
o fatigue
o mood swings
o lack of self awareness
Possible Complications
| COMPLICATION | CAUSES | PREVENTION |
Cerebral Vasospasm: brain vessels spasm and decrease blood flow to the brain |
Irritation caused by blood outside a blood vessel in the brain |
Medication; tight blood pressure control treatment in Neuro Interventional Radiology to inject medication to open blood vessel |
Re-bleeding: vessel bleeds again if untreated or after surgery |
High blood pressure, straining or bearing down to have a bowel movement, coughing, dehydration, inadequate healing |
Tight blood pressure control, decrease excitement and keep calm/quiet, no strenuous activities, avoid constipation, IV fluids, eat healthy to help healing, avoid caffeine |
Hydrocephalus: too much fluid in the brain |
Brain cannot drain cerebral spinal fluid (CSF) correctly because of swelling or bleeding |
Keep patient’s head elevated, position head in line with body, medications (steroids) to decrease swelling. |
Herniation: downward movement of brain causing pressure on the brainstem (the part of the brain that controls heart rate and breathing) |
Swelling, increased intracranial pressure (ICP) |
Medications; Surgery |
| Seizures | Blood surrounding brain tissue |
Medication, monitor intracranial pressure, seizure precautions to prevent injury during a seizure, decrease stimulation |
| Hyponatremia: low sodium | Hormone imbalance or increased intracranial pressure |
Sodium infusion, fluid limitation |
| Infection | Any invasive procedure/treatment: ventriculostomy, IV or PICC line, Foley catheter |
Hand washing |
Pneumonia: infection of the lung(s |
Bed rest, intubation (breathing assistance by a ventilator), aspiration (fluid or food goes “down the wrong tube” into the lungs) |
Coughing and deep breathing, use incentive spirometer, frequent oral care, elevate head of bed, swallow study, early extubation, early activity |
Thrombi (blood clots): can form in legs and travel to lungs causing pulmonary emboli |
Bed rest (not walking), central catheters (PICC line) |
Sequential Compression Devices (SCDs), TED hose (compression stocking), early activity |
How are these strokes treated?
• Surgery. For some patients a neurosurgeon may put in a drain or remove
part of the skull or brain.
• Hospital care. Since bleeding into the brain can be life threatening, hospital
care may be in an Intensive Care Unit.
• Drugs. Drugs can be used to lower blood pressure. Other drugs can help to
reduce swelling in the brain. They also can prevent seizures and decrease
the chance of blood clots forming in the legs.
• Rehabilitation. There is a focus on independence. We provide devices and
services which increase the number of things a person is able to do.
• Prevention. Doing all you can to prevent another stroke is a big part of
treatment. See Health Facts for You # 5736, “Things You Can Do To Reduce
Your Risk of Stroke”.
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 09/17/2012
Copyright © 09/17/2012 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#7420
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