BRAIN HEMORRHAGE
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INTRACEREBRAL HEMORRHAGE (ICH):
uncontrolled hypertension
ICH: PROGRESSION OF INNOCUOUS LOOKING BLEED
Small innocuous looking intracerebral hemorrhage can progress over time and may need surgery.
Uncontrolled Hypertension
Hypertensive Intracranial Haemorrhage ( Brain Haemorrhage) is a type of stroke, which is caused by the brain’s artery bursts and the blood spreads nearby areas, and bleeding starts from surrounding tissues. This bleeding permanently damages brain cells. In fact, hypertension is the most common cause of intracerebral hemorrhages.
Long-standing poorly controlled hypertension leads to a variety of pathological changes in the vessels. It can cause
1.microaneurysms of perforating arteries (Charcot-Bouchard aneurysms). They are usually
. small (0.3-0.9 mm) diameter
. occur on small (0.1-0.3 mm) diameter arteries
. distribution which matches the incidence of hypertensive haemorrhages (80% lenticulostriate, 10% pons, 10% cerebellum)
. found in hypertensive patients
. may thrombose, leak (see cerebral microhemorrhages) or rupture
2.accelerated atherosclerosis: affects larger vessels
3.hyaline arteriosclerosis, which is then generalised and can affect any artery in the body
Brain haemorrhage following untreated hypertension is worst, as it can cause rehaemorrhage even after surgery.
Not all hypertensive hemorrhage need surgery as shown below.