Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-745bb68f8f-b95js Total loading time: 0 Render date: 2025-01-11T13:53:28.177Z Has data issue: false hasContentIssue false

13 - Intracranial Hemorrhage

from Section 3 - Neurological Emergencies

Published online by Cambridge University Press:  02 November 2023

By
Matthew L. Wong  and
Joshua W. Joseph
Edited by
Kaushal Shah  and
Jarone Lee
Edited in association with
Clark G. Owyang  and
Benjamin Christian Renne
Kaushal Shah
Affiliation:
Weill Cornell Medical Center, New York
Jarone Lee
Affiliation:
Massachusetts General Hospital, Boston
Clark G. Owyang
Affiliation:
Weill Cornell Medical Center, New York
Benjamin Christian Renne
Affiliation:
Massachusetts General Hospital, Boston
Get access

Summary

  • Intracranial hemorrhage (ICH) occurs when blood occupies space within the calvarium. ICH irritates brain parenchyma and impairs outflow of cerebral spinal fluid (CSF) from the dural sinus venous network, which raises intracranial pressure (ICP) with a resultant decrease in cerebral perfusion.

  • ICH types are defined by the location of the bleeding: intracerebral (within the parenchyma), epidural (between the skull and the dura), subdural (between the dura and arachnoid membrane) and subarachnoid (between arachnoid membrane and pia mater).

  • The skull is inelastic, so blood accumulation increases intracranial pressure.

Keywords

cerebral bleedintracranial pressurecerebral perfusion pressurehead CT
Type
Chapter
Information
Practical Emergency Resuscitation and Critical Care , pp. 114 - 123
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Carney, N, Totten, AM, O’Reilly, C, et al. Guidelines for the management of severe traumatic brain injury. Neurosurgery 2017;80(1):6–15.CrossRefGoogle ScholarPubMed
Gross, BA, Jankowitz, BT, Friedlander, RM. Cerebral intraparenchymal hemorrhage: a review. JAMA 2019;321(13):1295–1303.CrossRefGoogle ScholarPubMed
Hemphill, JC 3rd, Greenberg, SM, Anderson, CS, et al. Guidelines for the management of spontaneous intracerebral hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2015;46:2032–2060.CrossRefGoogle ScholarPubMed
Marcolini, E, Stretz, C, DeWitt, KM. Intracranial hemorrhage and intracranial hypertension. Emerg Med Clin 2019;37(3):529–544.CrossRefGoogle ScholarPubMed
Qureshi, AI, Huang, W, Lobanova, I, et al. Outcomes of intensive systolic blood pressure reduction in patients with intracerebral hemorrhage and excessively high initial systolic blood pressure: post hoc analysis of a randomized clinical trial. JAMA Neurology 2020;77(11):1355–1365.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×