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Hypertensive Intracranial Hemorrhage
Karen L. Salzman, MD; Laurie A. Loevner, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          TERMINOLOGY

          • Abbreviations

            • Hypertensive intracranial hemorrhage (hICH)
          • Synonyms

            • Stroke, hypertensive hemorrhage
          • Definitions

            • Acute nontraumatic intracerebral hemorrhage (ICH) secondary to systemic hypertension (HTN)

          IMAGING

          • General Features

            • CT Findings

              • MR Findings

                • Angiographic Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Gross Pathologic & Surgical Features

                          • Microscopic Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        Selected References

                                        1. Koivunen RJ et al: Incidence, risk factors, etiology, severity and short-term outcome of non-traumatic intracerebral hemorrhage in young adults. Eur J Neurol. 22(1):123-32, 2015
                                        2. Marsh EB et al: Predicting symptomatic intracerebral hemorrhage versus lacunar disease in patients with longstanding hypertension. Stroke. 45(6):1679-83, 2014
                                        3. Shams S et al: Cerebral Microbleeds: Different Prevalence, Topography, and Risk Factors Depending on Dementia Diagnosis-The Karolinska Imaging Dementia Study. AJNR Am J Neuroradiol. ePub, 2014
                                        4. Wilson D et al: Advances in understanding spontaneous intracerebral hemorrhage: insights from neuroimaging. Expert Rev Neurother. 14(6):661-78, 2014
                                        5. Yang Z et al: Treatment of supratentorial spontaneous intracerebral hemorrhage using image-guided minimally invasive surgery: Initial experiences of a flat detector CT-based puncture planning and navigation system in the angiographic suite. AJNR Am J Neuroradiol. 35(11):2170-5, 2014
                                        6. Mehndiratta P et al: Cerebral amyloid angiopathy-associated intracerebral hemorrhage: pathology and management. Neurosurg Focus. 32(4):E7, 2012
                                        7. Zheng T et al: Vascular imaging adds value in investigation of basal ganglia hemorrhage. J Clin Neurosci. 19(2):277-80, 2012
                                        8. Dubow J et al: Impact of hypertension on stroke. Curr Atheroscler Rep. 13(4):298-305, 2011
                                        9. Shinohara Y et al: III. Intracerebral hemorrhage. J Stroke Cerebrovasc Dis. 20(4 Suppl):S74-99, 2011
                                        10. Bogucki J et al: A new CT-based classification of spontaneous supratentorial intracerebral haematomas. Neurol Neurochir Pol. 43(3):236-44, 2009
                                        11. Waran V et al: A new expandable cannula system for endoscopic evacuation of intraparenchymal hemorrhages. J Neurosurg. 111(6):1127-30, 2009
                                        12. Shah QA et al: Acute hypertension in intracerebral hemorrhage: pathophysiology and treatment. J Neurol Sci. 261(1-2):74-9, 2007
                                        13. Ferro JM: Update on intracerebral haemorrhage. J Neurol. 253(8):985-99, 2006
                                        14. Ohtani R et al: Clinical and radiographic features of lobar cerebral hemorrhage: hypertensive versus non-hypertensive cases. Intern Med. 42(7):576-80, 2003
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Clinical Issues

                                                TERMINOLOGY

                                                • Abbreviations

                                                  • Hypertensive intracranial hemorrhage (hICH)
                                                • Synonyms

                                                  • Stroke, hypertensive hemorrhage
                                                • Definitions

                                                  • Acute nontraumatic intracerebral hemorrhage (ICH) secondary to systemic hypertension (HTN)

                                                IMAGING

                                                • General Features

                                                  • CT Findings

                                                    • MR Findings

                                                      • Angiographic Findings

                                                        • Imaging Recommendations

                                                          DIFFERENTIAL DIAGNOSIS

                                                            PATHOLOGY

                                                            • General Features

                                                              • Gross Pathologic & Surgical Features

                                                                • Microscopic Features

                                                                  CLINICAL ISSUES

                                                                  • Presentation

                                                                    • Demographics

                                                                      • Natural History & Prognosis

                                                                        • Treatment

                                                                          DIAGNOSTIC CHECKLIST

                                                                          • Consider

                                                                            • Image Interpretation Pearls

                                                                              Selected References

                                                                              1. Koivunen RJ et al: Incidence, risk factors, etiology, severity and short-term outcome of non-traumatic intracerebral hemorrhage in young adults. Eur J Neurol. 22(1):123-32, 2015
                                                                              2. Marsh EB et al: Predicting symptomatic intracerebral hemorrhage versus lacunar disease in patients with longstanding hypertension. Stroke. 45(6):1679-83, 2014
                                                                              3. Shams S et al: Cerebral Microbleeds: Different Prevalence, Topography, and Risk Factors Depending on Dementia Diagnosis-The Karolinska Imaging Dementia Study. AJNR Am J Neuroradiol. ePub, 2014
                                                                              4. Wilson D et al: Advances in understanding spontaneous intracerebral hemorrhage: insights from neuroimaging. Expert Rev Neurother. 14(6):661-78, 2014
                                                                              5. Yang Z et al: Treatment of supratentorial spontaneous intracerebral hemorrhage using image-guided minimally invasive surgery: Initial experiences of a flat detector CT-based puncture planning and navigation system in the angiographic suite. AJNR Am J Neuroradiol. 35(11):2170-5, 2014
                                                                              6. Mehndiratta P et al: Cerebral amyloid angiopathy-associated intracerebral hemorrhage: pathology and management. Neurosurg Focus. 32(4):E7, 2012
                                                                              7. Zheng T et al: Vascular imaging adds value in investigation of basal ganglia hemorrhage. J Clin Neurosci. 19(2):277-80, 2012
                                                                              8. Dubow J et al: Impact of hypertension on stroke. Curr Atheroscler Rep. 13(4):298-305, 2011
                                                                              9. Shinohara Y et al: III. Intracerebral hemorrhage. J Stroke Cerebrovasc Dis. 20(4 Suppl):S74-99, 2011
                                                                              10. Bogucki J et al: A new CT-based classification of spontaneous supratentorial intracerebral haematomas. Neurol Neurochir Pol. 43(3):236-44, 2009
                                                                              11. Waran V et al: A new expandable cannula system for endoscopic evacuation of intraparenchymal hemorrhages. J Neurosurg. 111(6):1127-30, 2009
                                                                              12. Shah QA et al: Acute hypertension in intracerebral hemorrhage: pathophysiology and treatment. J Neurol Sci. 261(1-2):74-9, 2007
                                                                              13. Ferro JM: Update on intracerebral haemorrhage. J Neurol. 253(8):985-99, 2006
                                                                              14. Ohtani R et al: Clinical and radiographic features of lobar cerebral hemorrhage: hypertensive versus non-hypertensive cases. Intern Med. 42(7):576-80, 2003