Intracranial hemorrhage (ICH) refers to any form of bleeding within the skull. It can result from trauma, vascular abnormalities, hypertension, or other medical conditions. ICH is broadly categorized into several subtypes based on the location of the bleed: intracerebral hemorrhage (including intraparenchymal and intraventricular hemorrhages), subarachnoid hemorrhage, epidural hemorrhage, and subdural hematoma. Each subtype has distinct causes, clinical features, and treatment approaches.
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In this Dossier
Intracranial hemorrhage in the context of Stroke
Stroke is a medical condition in which poor blood flow to a part of the brain causes cell death. There are two main types of stroke: ischemic, due to lack of blood flow, and hemorrhagic, due to bleeding. Both cause parts of the brain to stop functioning properly.
Signs and symptoms of stroke may include an facial drooping, inability to walk, move or feel on one side of the body, problems understanding or speaking, dizziness, or loss of vision to one side. Signs and symptoms often appear soon after the stroke has occurred. If symptoms last less than 24 hours, the stroke is a transient ischemic attack (TIA), also called a mini-stroke. Hemorrhagic stroke may also be associated with a severe headache. The symptoms of stroke can be permanent. Long-term complications may include pneumonia and loss of bladder control.
Intracranial hemorrhage in the context of Hemophilia
Haemophilia (British English), or hemophilia (American English) (from Ancient Greek αἷμα (haîma) 'blood' and φιλία (philía) 'love of'), is a mostly inherited genetic disorder that impairs the body's ability to make blood clots, a process needed to stop bleeding. This results in people bleeding for a longer time after an injury, easy bruising, and an increased risk of bleeding inside joints or the brain. Those with a mild case of the disease may have symptoms only after an accident or during surgery. Bleeding into a joint can result in permanent damage while bleeding in the brain can result in long term headaches, seizures, or an altered level of consciousness.
There are two main types of haemophilia: haemophilia A, which occurs due to low amounts of clotting factor VIII, and haemophilia B, which occurs due to low levels of clotting factor IX. They are typically inherited from one's parents through an X chromosome carrying a nonfunctional gene. Most commonly found in men, haemophilia can affect women too, though very rarely. A woman would need to inherit two affected X chromosomes to be affected, whereas a man would only need one X chromosome affected. It is possible for a new mutation to occur during early development, or haemophilia may develop later in life due to antibodies forming against a clotting factor.
Intracranial hemorrhage in the context of Ventricular fibrillation
Ventricular fibrillation (V-fib or VF) is an abnormal heart rhythm in which the ventricles of the heart quiver. It is due to disorganized electrical activity. Ventricular fibrillation results in cardiac arrest with loss of consciousness and no pulse. This is followed by sudden cardiac death in the absence of treatment. Ventricular fibrillation is initially found in about 10% of people with cardiac arrest.
Ventricular fibrillation can occur due to coronary heart disease, valvular heart disease, cardiomyopathy, Brugada syndrome, long QT syndrome, electric shock, or intracranial hemorrhage. Diagnosis is by an electrocardiogram (ECG) showing irregular unformed QRS complexes without any clear P waves. An important differential diagnosis is torsades de pointes.