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Intracerebral Hemorrhage : Information for 
patients and families 
Vancouver General Hospital Intensive Care Unit 
Myp Sekhon MD 
Clinical Instructor, Staff Intensivist 
Vancouver General Hospital 
Division of Critical Care Medicine 
University of British Columbia
Outline 
Definition 
Causes 
Diagnosis 
Imaging 
Management 
Prognosis 
Definition 
An “intracerebral hemorrhage” is a bleed inside the brain 
that causes damage to the brain and surrounding 
structures 
Normal Brain 
Swelling around 
bleed 
Bleed inside 
brain
Outline 
Definition 
Causes 
Diagnosis 
Imaging 
Management 
Prognosis 
Causes – why did this bleed happen 
High blood pressure (hypertension) is the most common 
cause of this type of bleed 
Other less common causes include: 
•Trauma 
•Drugs 
•Blood thinners 
•Cancer 
•Abnormal blood vessels 
•Aneurysm or other less common problems
Outline 
Definition 
Etiologies 
Diagnosis 
Imaging 
Management 
Prognosis 
Diagnosis – how do we find 
out? 
A CT scan is able to show the presence of a bleed 
Sometimes, a detailed exam of the brain’s blood 
vessels (angiogram) is done to rule out diseases of 
the vessels (aneurysm etc.) 
Angiogram
Outline 
Definition 
Etiologies 
Diagnosis 
Imaging 
Management 
Prognosis 
Diagnosis - Imaging 
A bleed deep within the brain – characteristic of high blood 
pressure
Outline 
Definition 
Etiologies 
Diagnosis 
Imaging 
Management 
Prognosis 
Treatment 
Establish a cause 
•High blood pressure is the most common cause but 
some patients may need further tests 
Medical treatment 
•Blood pressure control – we use medications to 
control the BP to prevent another bleed 
•Ensure the patient’s blood is not thin 
•Often, we need to sedate patients with medications to 
allow the brain to heal 
•If patient’s are sedated then we assist their 
breathing with a machine (ventilator) 
Surgery 
•Surgery may be required but also comes with risks
Outline 
Definition 
Etiologies 
Diagnosis 
Imaging 
Management 
Prognosis 
Prognosis 
Predicting an outcome can be difficult, however, certain 
factors may help 
Factors associated with a bad outcome: 
•Older age 
•Previous multiple diseases (diabetes, kidney disease, 
heart disease, strokes etc) 
•Previous dependant functioning 
•Size of the original bleed 
•Decreased level of consciousness after the bleed 
•Location of the bleed 
•If the bleed occurs in vital areas of the brain, the 
outcome is usually worse
Outline 
Definition 
Etiologies 
Diagnosis 
Imaging 
Management 
Prognosis 
Questions 
Ask us! 
That’s what we are here for! 
VGH Intensive Care

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Intracerebral hemorrhage info for patients and families

  • 1. Intracerebral Hemorrhage : Information for patients and families Vancouver General Hospital Intensive Care Unit Myp Sekhon MD Clinical Instructor, Staff Intensivist Vancouver General Hospital Division of Critical Care Medicine University of British Columbia
  • 2. Outline Definition Causes Diagnosis Imaging Management Prognosis Definition An “intracerebral hemorrhage” is a bleed inside the brain that causes damage to the brain and surrounding structures Normal Brain Swelling around bleed Bleed inside brain
  • 3. Outline Definition Causes Diagnosis Imaging Management Prognosis Causes – why did this bleed happen High blood pressure (hypertension) is the most common cause of this type of bleed Other less common causes include: •Trauma •Drugs •Blood thinners •Cancer •Abnormal blood vessels •Aneurysm or other less common problems
  • 4. Outline Definition Etiologies Diagnosis Imaging Management Prognosis Diagnosis – how do we find out? A CT scan is able to show the presence of a bleed Sometimes, a detailed exam of the brain’s blood vessels (angiogram) is done to rule out diseases of the vessels (aneurysm etc.) Angiogram
  • 5. Outline Definition Etiologies Diagnosis Imaging Management Prognosis Diagnosis - Imaging A bleed deep within the brain – characteristic of high blood pressure
  • 6. Outline Definition Etiologies Diagnosis Imaging Management Prognosis Treatment Establish a cause •High blood pressure is the most common cause but some patients may need further tests Medical treatment •Blood pressure control – we use medications to control the BP to prevent another bleed •Ensure the patient’s blood is not thin •Often, we need to sedate patients with medications to allow the brain to heal •If patient’s are sedated then we assist their breathing with a machine (ventilator) Surgery •Surgery may be required but also comes with risks
  • 7. Outline Definition Etiologies Diagnosis Imaging Management Prognosis Prognosis Predicting an outcome can be difficult, however, certain factors may help Factors associated with a bad outcome: •Older age •Previous multiple diseases (diabetes, kidney disease, heart disease, strokes etc) •Previous dependant functioning •Size of the original bleed •Decreased level of consciousness after the bleed •Location of the bleed •If the bleed occurs in vital areas of the brain, the outcome is usually worse
  • 8. Outline Definition Etiologies Diagnosis Imaging Management Prognosis Questions Ask us! That’s what we are here for! VGH Intensive Care