Hypertensive intracerebral haemorrhage

Hypertensive intracerebral haemorrhages are common. In fact hypertension is the most common cause of intracerebral haemorrhages. They can be conveniently divided according to their typical locations which include, in order of frequency: 

Pathology

Long standing poorly controlled hypertension leads to a variety of pathological changes in the vessels.

  • microaneurysms of perforating arteries (Charcot-Bouchard aneurysms
    • small (0.3-0.9 mm) diameter 
    • occur on small (0.1-0.3 mm) diameter arteries
    • distribution which matches incidence of hypertensive haemorrhages
      • 80% lenticulostriate
      • 10% pons
      • 10% cerebellum
    • found in hypertensive patients
    • may thrombose, leak (see cerebral microhaemorrhages) or rupture 2
  • accelerated atherosclerosis: affects larger vessels
  • hyaline arteriosclerosis
  • hyperplastic arteriosclerosis: seen in very elevated and protracted cases

Stroke and intracranial haemorrhage
Share article

Article Information

rID: 13413
Section: Pathology
Synonyms or Alternate Spellings:
  • Hypertensive intracerebral haemorrhages
  • Hypertensive intracerebral hemorrhage
  • Hypertensive intracerebral hemorrhages
  • Hypertensive intracerebral bleed
  • Hypertensive intracranial bleed

Support Radiopaedia and see fewer ads

Cases and Figures

  • Drag
    Figure 1: Charcot Bouchard aneurysms
    Drag here to reorder.
  • Drag
    Case 1: basal ganglia haemorrhage
    Drag here to reorder.
  • Drag
    Case 2: pontine haemorrhage
    Drag here to reorder.
  • Drag
    Case 3: cerebellar haemorrhage
    Drag here to reorder.
  • Drag
    Case 4: periventricular haemorrhage
    Drag here to reorder.
  • Drag
    Case 5: thalamic haemorrhage
    Drag here to reorder.
  • Drag
    Case 6: cerebellar haemorrhage
    Drag here to reorder.
  • Drag
    Case 7: combined traumatic and hypertensive haemorrhage
    Drag here to reorder.
  • Drag
    Case 8: combined pontine and basal ganglia haemorrhages
    Drag here to reorder.
  • Updating… Please wait.
    Loadinganimation

    Alert accept

    Error Unable to process the form. Check for errors and try again.

    Alert accept Thank you for updating your details.