What are intracranial hemorrhage, cerebral hemorrhage, and hemorrhagic stroke?

An intracranial hemorrhage is a type of bleeding that occurs inside the skull (cranium).

Bleeding around or within the brain itself is known as a cerebral hemorrhage (or intracerebral hemorrhage). Bleeding caused by a blood vessel in the brain that has leaked or ruptured (torn) is called a hemorrhagic stroke. (All bleeding within the skull is referred to as intracranial hemorrhage.)

Hemorrhages that occur within the skull or brain generally happen suddenly, from either external or internal causes. A hemorrhage can rapidly cause brain damage and can be life-threatening.

Since the brain cannot store oxygen, it relies upon a series of blood vessels to supply oxygen and nutrients. When a hemorrhage occurs, oxygen may no longer be able to reach brain tissue supplied by leaky or broken blood vessels. Pooling of blood from an intracranial hemorrhage or cerebral hemorrhage also puts pressure on the brain and deprives it of oxygen.

When a hemorrhage or stroke interrupts blood flow around or inside the brain, depriving it of oxygen for more than three or four minutes, the brain cells die. The affected nerve cells and the related functions they control are damaged as well.

Who is affected by intracranial hemorrhage?

Stroke is the leading cause of disability and the fifth-leading cause of death in the United States. Intracranial hemorrhage accounts for approximately 10% of all strokes in the U.S.

Intracranial hemorrhage can strike people of any age, depending upon the cause. Although cerebral hemorrhage and hemorrhagic stroke are most commonly associated with older adults, they can also occur in children (pediatric stroke).

What are the causes of intracranial hemorrhage?

Intracranial hemorrhage has a number of causes, including:

  • Head trauma, such as that caused by a fall, car accident, sports accident, etc
  • Hypertensive (high blood pressure) damage to blood vessel walls that causes the blood vessel to leak or break
  • Blockage of an artery in the brain by a blood clot that formed in the brain or traveled to the brain from another part of the body, with subsequent leakage from the damaged artery
  • Ruptured cerebral aneurysm (a weak spot in a blood vessel wall that balloons out and bursts)
  • Buildup of amyloid protein within the artery walls of the brain (cerebral amyloid angiopathy)
  • Leaking of malformed arteries or veins (arteriovenous malformation)
  • Treatment with anticoagulant therapy (blood thinners)
  • Bleeding tumors
  • Smoking, excessive alcohol use, or use of illegal drugs such as cocaine
  • Conditions related to pregnancy or childbirth, including eclampsia, postpartum vas culopathy, or neonatal intraventricular hemorrhage

What are the symptoms of intracranial hemorrhage?

  • Sudden tingling, weakness, numbness, or paralysis of the face, arm or leg, particularly on one side of the body
  • Sudden, severe headache
  • Difficulty with swallowing or vision
  • Loss of balance or coordination
  • Difficulty understanding, speaking (slurring nonsensical speech), reading, or writing
  • Change in level of consciousness or alertness, marked by stupor, lethargy, sleepiness, or coma

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