Intracerebral Hemorrhage or Stroke
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An intracerebral hemorrhage (ICH) is caused by bleeding within the brain tissue itself — a life-threatening type of stroke. A stroke occurs when the brain is deprived of oxygen and blood supply.
What is an Intracerebral Hemorrhage (ICH)?
When the tiny, thin-walled arteries that bring blood to areas deep inside the brain rupture and release blood into the brain tissue, it is called an intracerebral hemorrhage (ICH). High blood pressure (hypertension), arteriovenous malformations (a group of incorrectly formed blood vessels), or head trauma can cause these thin-walled arteries to rupture and, because the brain is protected within the rigid skull, clotted blood and excess fluid increases the pressure that can crush the brain against the bone or cause it to shift and herniate. As blood collects, a hematoma or blood clot forms causing increased pressure on the brain. As blood spills into the brain, the area that the artery supplied is now deprived of oxygen-rich blood and causes a stroke. As blood cells within the clot die, toxins are released that further damage brain cells in the area surrounding the hematoma.
Intracerebral Hemorrhage (ICH)
This is bleeding that happens inside your brain. Most often, it’s a rupture of tiny arteries in your brain. It can happen deep within the brain, or near the brain’s surface. It leads to stroke and to a dangerous buildup of pressure in the brain.
What is a Stroke?
A stroke is a serious condition when the blood supply to your brain slows down or stops. They are caused by the blockage of an artery, which deprives the brain of oxygen. Because of this decrease in oxygen supply, within minutes, brain cells start to die.
This is a slow down or blockage of the blood that normally flows to part of your brain. When it happens, your brain cells don’t get the oxygen and nutrients they need. Within minutes, they begin to die.
What are the different types of Strokes?
Most strokes are ischemic which means when arteries to your brain start to narrow or become entirely blocked. There are two types of ischemic strokes: Thrombotic (starts in the brain) and embolic (starts away from the brain or heart or elsewhere).
- A thrombotic stroke happens when a blood clot develops in one of the arteries involved in delivering blood to your brain.
- An embolic stroke occurs when a blood clot or other type of debris develops away from your brain, often in your heart, and eventually gets stuck in smaller brain arteries.
Hemorrhagic strokes occur when one of the blood vessels in your brain either starts leaking or ruptures entirely. These types of strokes are often linked to high blood pressure (hypertension) weakened blood vessel walls (aneurysms), or possibly blood-thinning medications.
Transient Ischemic Attack
Nicknamed a “mini-stroke,” a transient ischemic attack is a temporary decrease in blood flow to your brain – without any permanent brain tissue damage. A transient ischemic attack (or TIA) dramatically increases your risk of having a full-blown stroke.
What are the symptoms of an Intracerebral Hemorrhage (ICH)?
Based on the location of the hemorrhage in the brain, symptoms can vary and appear suddenly. They may include sudden numbness or weakness in part of the face, difficulty speaking or walking, lethargy or confusion, temporary vision loss, seizures, and loss of consciousness. Emergency treatment is needed for cerebral hemorrhages.
How are Strokes and Intracerebral Hemorrhages Treated?
For ischemic strokes, if the patient seeks treatment within three hours of when symptoms begin, hospitals can administer a “clot-busting” medicine called t-PA to dissolve the blockage. For hemorrhagic strokes or ICH, treatment focuses on stopping the bleeding, removing the blood clot (hematoma), and relieving the pressure on the brain.
The Brain and Spine Institute of North Houston and Dr. Fayaz specialize in the surgical treatment of intracerebral hemorrhage. The goal of surgery is to remove as much of the blood clot as possible and stop the source of bleeding. Depending on the location of the clot either a craniotomy or a stereotactic aspiration may be performed.
- Craniotomy involves cutting a hole in the skull with a drill to expose the brain and remove the clot. Because of the increased risk to the brain, this technique is usually used only when the hematoma is close to the surface of the brain or if it is associated with Arteriovenous malformations or a tumor that must also be removed.
- Stereotactic clot aspiration is a less invasive surgery minimally invasive surgery for large hematomas located deep inside the brain. The procedure uses an image-guided needle placed directly into the clot. In this procedure, Dr. Fayaz drills a small burr hole about the size of a quarter in the skull (craniotomy). A thin tube is passed through the hole, through the brain tissue, directly into the clot. Then, he withdraws the liquid portion of the blood clot and inserts a smaller catheter to continue draining over the next days to weeks.
Treatment options are complex and risky; therefore, treatment should be provided by an expert with considerable experience in the surgical treatment of intracerebral hemorrhage. If you are experiencing any of the above symptoms, it is an emergency and you should call 911. However, if you need a consultation for surgery, Dr. Fayaz has the expertise and skill to treat this condition.
If you are in the North Houston, Conroe, The Woodlands, Spring area and believe you need to see a brain and spine specialist for an intracerebral hemorrhage or stroke, call our office at 281-880-0700 to schedule an appointment and consultation with Dr. Fayaz.