Intracerebral Hemorrhage (ICH) is an extremely serious condition, accounting for approximately 20–25% of all strokes. It is not only life-threatening but also carries a high risk of leaving severe residual disabilities. This disease is predominantly caused by hypertension, and the symptoms that appear vary significantly depending on the site of the bleeding (e.g., putamen, thalamus, cerebellum).
Main Types of Intracerebral Hemorrhage (Classification by Location)
| Type | Location | Frequency | Characteristics & Cause Tendency |
| Putaminal Hemorrhage | Deep within the cerebrum (near the putamen/thalamus) | Most Common (Approx. 50%) | Often caused by hypertension. |
| Thalamic Hemorrhage | Thalamus (related to sensation and consciousness) | Common | Prone to causing sensory deficits and impaired consciousness. |
| Subcortical Hemorrhage | Near the surface of the cerebrum | Relatively Common | Often related to AVMs (Arteriovenous Malformations) or Cerebral Amyloid Angiopathy. |
| Cerebellar Hemorrhage | Cerebellum | 5–10% | Sudden onset of headache, dizziness, and inability to walk. |
| Pontine Hemorrhage | Brainstem (Pons/Medulla) | Less Common | High risk of severe condition and high mortality rate. |
| Subarachnoid Hemorrhage (SAH) | Surface of the brain (Subarachnoid space) Often treated separately | N/A | Almost exclusively caused by ruptured cerebral aneurysms. |
*Note: Currently, Subarachnoid Hemorrhage (SAH) is often treated as a separate category from Intracerebral Hemorrhage (although both are types of stroke).
Main Causes and Risk Factors
- Hypertension (The most common cause, especially in people in their 50s to 70s)
- Rupture of a Cerebral Aneurysm
- Arteriovenous Malformation (AVM) (Especially in younger individuals)
- Cerebral Amyloid Angiopathy (More common in the elderly)
- Use of Anticoagulant / Antiplatelet Drugs (Warfarin, Rivaroxaban, Aspirin, etc.)
- Heavy Alcohol Consumption
- Bleeding from a brain tumor, head trauma, etc.
Common Symptoms (Sudden Onset!)
- Sudden severe headache (“Worst headache of my life”)
- Nausea and vomiting
- Paralysis or numbness in the limbs (often one side)
- Difficulty speaking or inability to understand speech
- Clouded consciousness ∼ Coma
- Double vision or distorted vision
- Inability to walk, dizziness
→ If these symptoms appear suddenly, call an ambulance immediately! (It is a race against time.)
Basic Treatment
Acute Phase (Immediately after onset ∼ a few days)
- Blood Pressure Management (Neither too high nor too low is acceptable)
- Medication to control Brain Swelling (Cerebral Edema)
- Mechanical ventilation, if necessary
- Emergency surgery (Craniotomy and Hematoma Evacuation or Ventricular Drainage) if bleeding is large and life-threatening
Recovery and Rehabilitation Phase
- Start rehabilitation as early as possible (to prevent being bedridden)
- Specialized rehabilitation for paralysis and speech impairment
Essential Steps for Preventing Recurrence
- Strictly control blood pressure (Target is generally below 130/80 mmHg)
- Quit smoking and moderate alcohol consumption
- Adhere strictly to a doctor’s instructions for anticoagulant/antiplatelet medications
- Undergo regular brain checkups (Brain Dock/MRI), especially if there is a family history of ICH or SAH
Summary
If you experience “Sudden severe headache + limb paralysis or impaired consciousness,” call 911 (or your local emergency number) immediately!
Furthermore, maintaining good blood pressure control on a daily basis is the most important prevention measure. If you have any concerning symptoms or a family history of ICH, please do not hesitate to consult a neurosurgeon or neurologist.
