ICB stands for intracerebral hemorrhage. An intracerebral hemorrhage (ICB or IZB) is bleeding within the brain tissue. It is a hemorrhagic stroke that presents with symptoms similar to those of an ischemic stroke. The prognosis of this bleeding depends on its location in the brain, its severity and the start and course of medical treatment.
What is an intracerebral hemorrhage?
The symptoms of intracerebral hemorrhage (hemorrhagic stroke) are similar to those of ischemic stroke. In both cases, certain brain regions die off. See AbbreviationFinder for abbreviations related to ICB.
About 15 percent of all strokes are caused by bleeding into the brain tissue (hemorrhagic stroke). The remaining 85 percent are the result of reduced blood flow to certain brain regions. In both cases, brain tissue dies.
The symptoms and course of a hemorrhagic stroke depend on the region of their occurrence in the brain and the severity of the bleeding. Furthermore, the right therapy and the time at which emergency measures are started are also decisive for the chances of recovery. Cerebral hemorrhage usually occurs when small arterial blood vessels burst. However, an intracerebral hemorrhage can also be caused by an injury to venous blood vessels.
The causes are manifold. Diseases of blood vessels, coagulation disorders, taking anticoagulants, vascular malformations and much more play a role. Around one million hemorrhagic strokes are observed worldwide. This affects around 90,000 people in the European Union. However, there are strong regional differences that can possibly be explained by special environmental conditions, lifestyles or genetic predispositions.
The most important cause of intracerebral hemorrhage is arterial hypertension. This risk factor has been identified in 70 to 80 percent of all people with a hemorrhagic stroke. The risk is also increased when taking anticoagulant medication.
The preventive treatment of leg vein thrombosis, heart attacks or ischemic sleep attacks with anticoagulants even increases the risk of cerebral hemorrhage by up to 11 times. Furthermore, the administration of acetylsalicylic acid after a heart attack or ischemic stroke leads to an increased risk of suffering a cerebral hemorrhage.
This becomes particularly clear when several anticoagulant preparations are combined. The same applies to people with blood clotting disorders. Blood vessel disorders may also play a role in the etiology of intracerebral hemorrhage.
Arterial diseases include, but are not limited to, acquired and genetic alterations of the small arterial blood vessels, amyloid angiopathy, cerebral aneurysm, vasculitis, moyamoya, and other large artery diseases. Furthermore, vascular malformations can trigger cerebral hemorrhage.
Cerebral hemorrhages are also possible due to brain metastases. Sometimes the cause cannot be identified. In these cases, it is an idiopathic or cryptic intracerebral hemorrhage. Overall, it has been found that drinking alcohol and smoking increases the risk of cerebral hemorrhage.
Symptoms, Ailments & Signs
The symptoms of intracerebral hemorrhage (hemorrhagic stroke) are similar to those of ischemic stroke. In both cases, certain brain regions die off. However, the symptoms and course of the stroke depend on the brain region affected and the extent of the dead area.
Headaches, nausea, vomiting, paralysis of the legs, arms or face on one side, numbness, speech, vision or swallowing disorders as well as dizziness, disturbances of consciousness and even epileptic seizures occur in varying degrees. It was found that the risk of an epileptic seizure in a hemorrhagic stroke is significantly greater than in an ischemic stroke.
An epileptic seizure occurs particularly frequently within 24 hours after the cerebral hemorrhage. In one third of the patients with intracerebral hemorrhage, potentials typical of epilepsy were found in the EEG without an epileptic seizure necessarily occurring. A hemorrhagic stroke can also lead to psychological changes, which are expressed, for example, in sudden changes in feelings and behavior as well as in states of confusion and even coma.
Diagnosis & course of disease
Cerebral hemorrhage can be reliably detected by computed tomography of the skull and can be differentiated from a hemorrhagic stroke. Alternatively, an MRI examination is also possible.
In most cases, this bleeding causes certain areas of the brain to die. The further course of the disease depends heavily on the affected region and the duration of this bleeding. Patients often suffer from severe headaches, vomiting and nausea. Paralysis also occurs in various regions of the body, so that the affected person may not be able to move their arms and legs.
This often leads to severe restrictions in movement and also to significant restrictions in the patient’s everyday life. As the bleeding progresses, the patient may have an epileptic seizure. The quality of life of those affected is significantly reduced and limited. It is not uncommon for the damage to the brain to have a negative effect on the actions and thinking of those affected, which can lead to confusion or even a coma.
The relatives can also suffer psychologically from the situation. This bleeding is treated by an emergency doctor. Possible consequential damages can be limited. In most cases, however, the life expectancy of the patient is reduced.
When should you go to the doctor?
People who experience repeated headaches, nausea, vomiting, and dizziness should consult a doctor. If the symptoms increase in intensity, medical help is required. If attention, concentration or memory disorders occur, this is a cause for concern and must be medically clarified. A doctor is needed for speech problems, communication failures, swallowing difficulties and various functional disorders. Disruptions in vision, hearing, or other sensory modalities should be evaluated and treated.
In the event of sensory disturbances, numbness or signs of paralysis, it is advisable to consult a doctor as soon as possible. If there is a clouding of consciousness or loss of consciousness, an ambulance must be called. If epileptic seizures occur, disorientation sets in or breathing stops, an emergency service must be alerted. Until it arrives, first aid measures must be taken.
It is a life-threatening condition that requires intensive medical care. Behavioral problems or changes in personality are brain changes that must be treated and diagnosed immediately by a doctor. Sudden and unexpected abnormalities are a special warning in the case of intracerebral hemorrhage. Immediate action and medical attention are necessary to ensure the survival of the victim. In many cases, the affected person can no longer move his limbs and hardly reacts to questions asked.
Treatment & Therapy
The ICB is an emergency that needs to be treated as soon as possible. The patient is admitted to a neurological or neurosurgical intensive care unit for treatment. The first step is usually to lower the arterial blood pressure to stop the bleeding.
However, the reduction in blood pressure is quite controversial because it could lead to reduced blood flow in the region of intracerebral hemorrhage. In the majority of cases, however, lowering blood pressure has proven beneficial. Furthermore, if the body temperature is increased, it should be lowered. Excessive body temperature has an unfavorable effect on the course of the disease.
In some cases, neurosurgical treatment is also performed. This depends on the cause of the bleeding, its localization and the course. If the bleeding occurs in the area of the cerebrum, surgical treatment is carried out only in exceptional cases. This consists, among other things, of removing the hematoma in the event of a serious deterioration in the state of consciousness.
If the bleeding is located infratentorially in the area of the cerebellum, relief surgery often helps if the condition worsens. If potentials typical of epilepsy are detected during the EEG examination, therapy with anticonvulsants should be carried out to prevent epileptic seizures.
Outlook & Forecast
The prognosis of intracerebral hemorrhage depends on the location of the irregularities. The severity of the bleeding and the course of the disease are also decisive. In severe cases and without medical care, the person concerned faces premature death. Many die from a stroke or heart attack. Normally, intensive care treatment is necessary to ensure the patient’s survival. The sooner medical care takes place, the greater the chances of survival. In addition, the permanent impairments and disturbances are reduced.
In many cases, long-term health irregularities occur despite rapid and professional therapy. Familiar obligations in everyday life can no longer be carried out as usual and without help. General functional disorders and losses in physical and mental performance occur. They lead to a reduced quality of life and can trigger secondary diseases. In particular, the mental resilience of the patient and their relatives increases and can trigger further diseases.
Numerous therapies are necessary to achieve a gradual improvement in general health. A freedom from complaints is not documented. The younger a patient is, the faster intensive medical treatment takes place and the fewer complications occur, the better the prognosis. In addition, the general state of health of the person concerned must be taken into account.
The most important measure to prevent intracerebral hemorrhage is to prevent hypertension. This can be achieved through a healthy lifestyle with a balanced diet, plenty of exercise and abstinence from alcohol and smoking. If blood pressure is already chronically elevated, a change in lifestyle should also be followed by medication to lower blood pressure.
Follow-up care begins after the acute treatment of the intracerebral hemorrhage. This consistently continues the rehabilitation measures that have already been initiated. Depending on the individual situation, the patients can not only take part in physiotherapeutic and ergotherapeutic measures, but also take advantage of speech therapy and neuropsychological care.
Prophylaxis against high blood pressure is particularly important in order to avoid recurrence of the disease. This includes a balanced lifestyle. Eating healthy, being physically active and not smoking or drinking alcohol minimizes the risk. If blood pressure is chronically high, those affected can also take medication to lower blood pressure. This is prescribed by the doctor treating you.
After the actual treatment, the patients first have a rest phase to rest. During this time, you should not put too much strain on your body and avoid sports. Psychological stress can also have a negative effect and should therefore be avoided. Regular medical examinations are a must for good control.
Any complications are noticed immediately and the doctor can intervene in good time. Depending on the severity of the condition, psychological therapy may be useful. As part of such treatment or in a self-help group, those affected learn to get used to their situation. They should not do without this professional and social support.
You can do that yourself
An intracerebral hemorrhage is a medical emergency that requires immediate attention. The first responders must provide first aid and immediately take the person concerned to the nearest hospital or call in the emergency services.
After the treatment in the clinic, the patient needs rest and protection. It is advisable not to do any sport for a few days and also to avoid mental stress. In addition, regular check-ups by the doctor are indicated. This can ensure that the disease does not lead to any serious complications. If any unusual symptoms appear, the doctor in charge must be informed. Sometimes the person concerned needs psychological treatment. Talking to a therapist is particularly useful in the case of heavy bleeding that has resulted in a panic attack. Chronically ill people should also seek professional support and, if necessary, visit a self-help group.
Conservative measures, such as good wound care, cooling and rest, help with hematomas. With belladonna and arnica , homeopathy offers two effective preparations that relieve swelling and reduce pain. The use of these funds should first be discussed with the doctor.