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Review Article
Medical Progress
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Volume 344:1450-1460 May 10, 2001 Number 19
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Spontaneous Intracerebral Hemorrhage
Adnan I. Qureshi, M.D., Stanley Tuhrim, M.D., Joseph P. Broderick, M.D., H. Hunt Batjer, M.D., Hideki Hondo, M.D., and Daniel F. Hanley, M.D.

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Nontraumatic intracerebral hemorrhage is bleeding into the parenchyma of the brain that may extend into the ventricles and, in rare cases, the subarachnoid space. Each year, approximately 37,000 to 52,400 people in the United States have an intracerebral hemorrhage.1,2 This rate is expected to double during the next 50 years as a result of the increasing age of the population and changes in racial demographics. Intracerebral hemorrhage accounts for 10 to 15 percent of all cases of stroke and is associated with the highest mortality rate, with only 38 percent of affected patients surviving the first year.3 Depending on the . . . [Full Text of this Article]

Epidemiologic Features

Incidence

Risk Factors

Pathophysiological Features

Pathologic Process

Origin of Hematoma

Progression of Hematoma

Secondary Neuronal Injury after Intracerebral Hemorrhage

Clinical Features

Neurologic Status at Presentation

Secondary Deterioration

Outcome

Diagnosis

Management

Evaluation and Management in the Emergency Room

Intensive Monitoring of Neurologic and Cardiovascular Status

Mass Effect and Intracranial Hypertension

Management of Blood Pressure

Ventricular Blood and Hydrocephalus

Surgical Evacuation

Seizures and Recurrent Hemorrhage

Future Directions


Source Information

From the Department of Neurology, Johns Hopkins Hospital, Baltimore (A.I.Q., D.F.H.); the Department of Neurology, Mount Sinai Medical Center, New York (S.T.); the Department of Neurology, University of Cincinnati College of Medicine, Cincinnati (J.B.P.); the Department of Neurological Surgery, Northwestern University Medical School, Chicago (H.H.B.); and the Department of Neurological Surgery, Tokushima Prefectural Central Hospital, Tokushima, Japan (H.H.).

Address reprint requests to Dr. Qureshi at the Department of Neurosurgery, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Millard Fillmore Hospital, 3 Gates Cir., Buffalo, NY 14209-1194, or at aiqureshi@hotmail.com.

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