Intraparenchymal hemorrhage.

Abstract

Spontaneous hemorrhage into the cerebral parenchyma accounts for 8% to 13% of all strokes. It is more common in males, in blacks, and in the elderly. Fifty percent of cases are due to the effects of chronic hypertension on intracranial perforating arteries. The basal ganglia are the most frequent site of bleeding. Lobar hematomas tend to occur in younger patients, and may be due to specific causes such as vascular malformations. Many patients will have increased intracranial pressure and will require treatment in an intensive care unit. If surgery is necessary, stereotactic aspiration and pharmaceutical clot lysis are recent developments that may be advantageous. Prognosis is related to the patient's age and neurologic condition, and to the size, location, and rapidity of formation of the hematoma.