Classification & external resources
|| I60.0-I62., S06.
|| 430-432, 850-854
An intracranial hemorrhage is a hemorrhage, or bleeding, within the skull.
Additional recommended knowledge
Intracranial bleeding occurs when a blood vessel in the head is ruptured or leaks. It can result from physical trauma (as occurs in head injury) or nontraumatic causes (as occurs in hemorrhagic stroke) such as a ruptured aneurysm.
Intracranial hemorrhage is a serious medical emergency because the buildup of blood within the skull can lead to increases in intracranial pressure, which can crush delicate brain tissue or limit its blood supply. Intracranial bleeds with a lot of bleeding are more dangerous than those with not as much blood.
CAT scan (computed axial tomography) is the definitive tool for accurate diagnosis of an intracranial hemorrhage.
Types of intracranial hemorrhage are roughly grouped into intra-axial and extra-axial.
Intra-axial hemorrhage is bleeding within the brain itself. This category includes:
Extra-axial hemorrhage, bleeding that occurs within the skull but outside of the brain tissue, falls into three subtypes:
- Epidural hemorrhage is caused by trauma, and results from laceration of an artery, most commonly the middle meningeal artery. This is a very dangerous type of injury because the bleed is from a high-pressure system and deadly increases in intracranial pressure can result rapidly.
- Patients have a loss of consciousness (LOC), then a lucid interval, then sudden deterioration (vomiting, restlessness, LOC)
- Head CT shows lenticular (convex) deformity.
- Subdural hemorrhage results from tearing of the bridging veins in the subdural space between the dura and arachnoid mater.
- Head CT shows crescent-shaped deformity
- Subarachnoid hemorrage, like intraparenchymal hemorrhage, can result either from trauma or from ruptures of aneurysms or arteriovenous malformations. Blood is seen layering into the brain along sulci and fissures, or filling cisterns (most often the suprasellar cistern because of the presence of the vessels of the circle of Willis and their branchpoints within that space). The classic presentation of subarachnoid hemorrhage is the sudden onset of a severe headache. This can be a very dangerous entity, and requires emergent neurosurgical evaluation, and sometimes urgent intervention.
- Graham DI and Gennareli TA. Chapter 5, "Pathology of Brain Damage After Head Injury" Cooper P and Golfinos G. 2000. Head Injury, 4th Ed. Morgan Hill, New York.
- McCaffrey P. 2001. "The Neuroscience on the Web Series: CMSD 336 Neuropathologies of Language and Cognition." California State University, Chico.
- Orlando Regional Healthcare, Education and Development. 2004. "Overview of Adult Traumatic Brain Injuries." Retrieved on September 6, 2007.
- Shepherd S. 2004. "Head Trauma." Emedicine.com.
- Vinas FC and Pilitsis J. 2004. "Penetrating Head Trauma." Emedicine.com.
|Circulatory system pathology (I, 390-459)|
|Hypertension||Hypertensive heart disease - Hypertensive nephropathy - Secondary hypertension (Renovascular hypertension)|
|Ischaemic heart disease||Angina pectoris (Prinzmetal's angina) - Myocardial infarction - Dressler's syndrome|
|Pulmonary circulation||Pulmonary embolism - Cor pulmonale|
|Pericardium||Pericarditis - Pericardial effusion - Cardiac tamponade|
|Endocardium/heart valves||Endocarditis - mitral valves (regurgitation, prolapse, stenosis) - aortic valves (stenosis, insufficiency) - pulmonary valves (stenosis, insufficiency) - tricuspid valves (stenosis, insufficiency)|
|Myocardium||Myocarditis - Cardiomyopathy (Dilated cardiomyopathy, Hypertrophic cardiomyopathy, Loeffler endocarditis, Restrictive cardiomyopathy) - Arrhythmogenic right ventricular dysplasia|
|Electrical conduction system|
of the heart
|Heart block: AV block (First degree, Second degree, Third degree) - Bundle branch block (Left, Right) - Bifascicular block - Trifascicular block|
Pre-excitation syndrome (Wolff-Parkinson-White, Lown-Ganong-Levine) - Long QT syndrome - Adams-Stokes syndrome - Cardiac arrest - Sudden cardiac death
Arrhythmia: Paroxysmal tachycardia (Supraventricular, AV nodal reentrant, Ventricular) - Atrial flutter - Atrial fibrillation - Ventricular fibrillation - Premature contraction (Atrial, Ventricular) - Ectopic pacemaker - Sick sinus syndrome
|Other heart conditions||Heart failure - Cardiovascular disease - Cardiomegaly - Ventricular hypertrophy (Left, Right)|
|Cerebrovascular diseases||Intracranial hemorrhage/cerebral hemorrhage: Extra-axial hemorrhage (Epidural hemorrhage, Subdural hemorrhage, Subarachnoid hemorrhage)|
Intra-axial hematoma (Intraventricular hemorrhages, Intraparenchymal hemorrhage) - Anterior spinal artery syndrome - Binswanger's disease - Moyamoya disease
|Atherosclerosis (Renal artery stenosis) - Aortic dissection/Aortic aneurysm (Abdominal aortic aneurysm) - Aneurysm - Raynaud's phenomenon/Raynaud's disease - Buerger's disease - Vasculitis/Arteritis (Aortitis) - Intermittent claudication - Arteriovenous fistula - Hereditary hemorrhagic telangiectasia - Spider angioma|
|Veins, lymphatic vessels|
and lymph nodes
|Thrombosis/Phlebitis/Thrombophlebitis (Deep vein thrombosis, May-Thurner syndrome, Portal vein thrombosis, Venous thrombosis, Budd-Chiari syndrome, Renal vein thrombosis, Paget-Schroetter disease) - Varicose veins / Portacaval anastomosis (Hemorrhoid, Esophageal varices, Varicocele, Gastric varices, Caput medusae) - Superior vena cava syndrome - Lymph (Lymphadenitis, Lymphedema, Lymphangitis)|
|Other||Hypotension (Orthostatic hypotension)|
|See also congenital (Q20-Q28, 745-747) |