Intracerebral hemorrhage is hemorrhage or bleeding into brain tissue. In children hemorrhage usually occurs due to abnormalities of the blood vessels (such as arteriovenous malformations, arteriovenous fistula, cavernous malformation, aneurysms, and moyamoya) or blood clotting. In adults the most common cause is high blood pressure; however, this is rarely the cause in children.

Symptoms

The symptoms of intracerebral hemorrhage can include sudden, severe headache, especially with vomiting or and sleepiness, weakness of one side of the body, slurred speech, new onset of seizure, or loss of consciousness after one of the above symptoms.

Diagnosis

Computed tomography (CT) will show the hemorrhage, and further testing may include a magnetic resonance imaging (MRI) scan. Depending on the results of the CT and/or MRI, further imaging may be requested. An angiogram (also called arteriogram) is a special test in which a neuroradiologist injects dye into the blood vessels in the brain and obtains images of the blood vessels. This test may be done when the diagnosis is unclear or to help plan treatment of a problem with the blood vessels. Other testing may include blood tests for clotting abnormalities.

Treatment

Treatment will depend on the cause of the child’s hemorrhage but may include surgical and endovascular treatments for abnormalities of blood vessels (endovascular means that a catheter is passed through the groin up into the arteries in the brain) and correction of blood clotting abnormalities if they are present.