Cerebral Hemorrhage: What is it? Causes, Symptoms, Diagnosis, Complications, Treatment and Prevention

This is a medical emergency that requires immediate treatment. ICH is not as common as ischemic stroke.

Bleeding around or within the brain itself is called a cerebral hemorrhage (or intracerebral hemorrhage)

Intracerebral hemorrhage (ICH) occurs when blood suddenly breaks into brain tissue and causes brain damage.

Symptoms usually appear suddenly during ICH. They include headache, weakness, confusion, and paralysis, particularly on one side of your body.

The buildup of blood puts pressure on your brain and interferes with your oxygen supply. This can cause brain and nervous damage quickly.

Treatment depends on the amount of blood and the extent of the brain injury.

Because the most common cause of HIC is related to high blood pressure, getting low blood pressure under control is the first critical step.


Surgery is sometimes required to relieve the pressure of blood collection and repair damaged blood vessels.

Long-term treatment depends on the location of the bleeding and the amount of damage.

Treatment may include physical, speech, and occupational therapy. Many people have some level of permanent disability.


High blood pressure is the most common cause of ICH. In younger people, another common cause is abnormally formed blood vessels in the brain.

Other causes include:

  • Head injury or trauma.
  • Brain aneurysm rupture (a weak spot in a blood vessel that bursts).
  • Arteriovenous malformation (a cluster of malformed blood vessels in your brain that interrupts normal blood flow).
  • Use of anticoagulants.
  • Bleeding tumors
  • Use of cocaine or methamphetamine (which can cause severe hypertension and cause bleeding).
  • Bleeding disorders (for example, hemophilia or sickle-cell anemia ).
  • Anyone can have a HIC, but their risk increases with age.

According to the Mayfield Clinic, men are slightly more at risk than women. Middle-aged people of Japanese or African-American descent are also at risk of ICH.


Symptoms of ICH include:

  • Sudden weakness, tingling, or paralysis of your face, arm, or leg, mainly if it occurs only on one side of your body.
  • Sudden onset of severe headache.
  • Difficulty swallowing
  • Problems with vision in one or both eyes.
  • Loss of balance and coordination, dizziness.
  • Challenges with language skills (reading, writing, speaking, understanding).
  • Vomiting nausea.
  • Drowsiness, lethargy, loss of consciousness, confusion, and delirium.

How is cerebral hemorrhage diagnosed?

If you have some symptoms of HIC, a doctor will perform a neurological exam.

Imaging tests determine whether you have an ischemic stroke (blockage) or a hemorrhagic (bleeding).

Diagnostic tests for ICH may include a CT scan.

This type of test creates images of your brain, confirming bleeding and evaluating other head trauma tests.

An MRI can help your doctor see your brain more clearly to better identify the cause of the bleeding.

An angiogram uses X-ray technology to take pictures of the blood flow within an artery. It can reveal abnormalities with the blood vessels themselves, such as aneurysms or arteriovenous malformations.

Blood tests can identify immune system disorders, inflammation, and blood clotting problems that can cause bleeding in the brain.

What are the complications of cerebral hemorrhage?

Depending on the location of the bleeding and how long your brain was without oxygen, complications may include:

  • Language problems.
  • Fatigue.
  • Problems swallowing
  • Sight loss.
  • Difficulty with sensations or movements on one side of the body.
  • Pneumonia.
  • Cognitive dysfunction (loss of memory, difficulty in reasoning).
  • Confusion.
  • Swelling in the brain
  • Convulsions
  • Depression, emotional problems.
  • Fever.

How is cerebral hemorrhage treated?

Treatment within the first three hours of symptoms generally results in a better outcome.

Surgery can relieve pressure on your brain and repair broken arteries. Certain medications can help control symptoms, such as painkillers to relieve severe headaches.

Drugs may be necessary to control blood pressure. If your doctor determines that you are at risk for seizures, you may need to take anti-epileptic medications.

Long-term treatment will be needed to overcome the symptoms caused by damage to your brain.

Depending on your symptoms, treatment may include physical and speech therapy to help restore muscle function or improve communication.

Occupational therapy can help you regain specific skills and independence by practicing and modifying everyday activities.

How can I prevent brain hemorrhage?

You can decrease your chances of ICH by:

  • No Smoking.
  • Treat heart disease
  • Treat high blood pressure.
  • Keeping diabetes under control
  • Maintain a healthy lifestyle

What is the long-term perspective?

Recovery after ICH differs significantly from person to person and will depend on various factors. These include your age and general health, the location of the bleeding, and the extent of the damage.

Some people may take months or years to recover. The majority of patients with ICH have some long-term disability.

In some cases, you may need medical attention 24 hours a day or in a nursing home.

LCA support groups can help individuals and families cope with long-term care. Your doctor or hospital can give you information about support groups in your area.