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:
- basal ganglia haemorrhage (especially the putamen)
- thalamic haemorrhage
- pontine haemorrhage
- cerebellar haemorrhage
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
Related articles
Stroke and intracranial haemorrhage
-
stroke and intracranial haemorrhage
-
ischaemic stroke
- general discussions
- scoring and classification systems
- signs
- by region
- hemispheric infarcts
- frontal lobe infarct
- parietal lobe infarct
- temporal lobe infarct
- occipital lobe infarct
- alexia without agraphia syndrome: PCA
- cortical blindness syndrome (Anton syndrome): top of basilar or bilateral PCA
- Balint syndrome: bilateral PCA
- internal capsule infarct
- ataxic hemiparesis syndrome: MCA perforators or basilar artery perforators
- lacunar infarct
- thalamic infarct
- Déjerine-Roussy syndrome (thalamic pain syndrome): thalamoperforators of PCA
- top of the basilar syndrome
- striatocapsular infarct
- cerebellar infarct
-
brainstem infarct
-
midbrain infarct
- Benedikt syndrome: PCA
- Claude syndrome: PCA
- Nothnagel syndrome: PCA
- Weber syndrome: PCA
-
pontine infarct
- Brissaud-Sicard syndrome
- facial colliculus syndrome
- Gasperini syndrome: basilar artery or AICA
- inferior medial pontine syndrome (Foville syndrome): basilar artery
- lateral pontine syndrome (Marie-Foix syndrome): basilar artery or AICA
- locked-in syndrome: basilar artery
- Millard-Gubler syndrome: basilar artery
- Raymond syndrome: basilar artery
-
medullary infarct
- Babinski-Nageotte syndrome
- hemimedullary syndrome (Reinhold syndrome)
- lateral medullary stroke syndrome (Wallenberg syndrome)
- medial medullary syndrome (Déjerine syndrome)
-
midbrain infarct
- acute spinal cord ischaemia syndrome
- hemispheric infarcts
- by vascular territory
- treatment options
- complications
-
intracranial haemorrhage
-
intra-axial haemorrhage
- signs
- by region or type
- extra-axial haemorrhage
-
intra-axial haemorrhage
-
ischaemic stroke
Unable to process the form. Check for errors and try again.