Spontan intracerebral blødning

Background. Cerebral stroke caused by intracerebral hemorrhage is serious. This review presents updated knowledge about the condition. Material and methods. The review is based on pivotal articles published during recent years, identified through a PubMed search applying the key words «intracerebral haemorrhage», and our own clinical experience. Results and interpretation. Intracerebral hemorrhage strikes about 1 000 persons in Norway annually. Hypertension is the single most important risk factor. Cerebral CT confirms the diagnosis. Almost half of the patients die during the first month after the hemorrhage, many during the first two days. About 20% of the patients can manage without help after the first six months. Treatment includes measures against increased intracranial pressure and in selected cases surgical evacuation of the haematoma, especially in cases of bleeding into the cerebellum. Recombinant factor VIIa infused within the first three hours to stop the bleeding can play an important role in the acute phase. Patients below the age of 45, patients without hypertension, and patients with lobar haemorrhage and signs of clinical deterioration should be thoroughly investigated to disclose a potential arteriovenous malformation or an aneurysm. Neurointensive care may give better clinical results and the condition should ideally be treated in an intensive care unit.