Intracerebral hemorrhage

Intracranial hemorrhage is defined as the pathological accumulation of blood (hematoma) within the cranial vault, resulting in clinical dysfunction of the nervous system. The accumulation can occur within the parenchyma (intracerebral hemorrhage), the surrounding meningeal spaces (subarachnoid hemorrhage), or into the ventricles (intraventricular hemorrhage). Bleeding inside the skull that results in epidural and subdural hematoma is usually traumatic in origin (head injury). Intracerebral hemorrhage (ICH) is more than twice as common as subarachnoid hemorrhage [1]. Nontraumatic intracerebral hemorrhage has several causes (Table 1), but it is most commonly caused by hypertension [primary or spontaneous intracerebral hemorrhage (PICH)]. Hypertensive ICH is often life-threatening, accounting for approximately 5–10% of strokes. Hemorrhages attributed to hypertension usually originate in the putamen, globus pallidum, thalamus, internal capsule, deep perventricular white matter, pons, or cerebellum. This chapter focuses on this type of hemorrhagic stroke because most clinical research has focused on this entity.