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Computed Tomography📍 BrainUpdated 2025-12-15Radiology Reviewed

Intracerebral Hemorrhage (ICH)

Understanding Intracerebral Hemorrhage (ICH) found on Brain Computed Tomography imaging. Learn what this finding means and what steps to take next.

Radiographic Appearance

Computed Tomography Finding

Hyperdense parenchymal bleed with surrounding edema; possible intraventricular extension and midline shift.

Clinical Significance

Neurocritical emergency; size, location, and mass effect guide management.

What is ICH?

Bleeding within the brain tissue, commonly due to hypertension, amyloid angiopathy, or anticoagulation. Non-contrast CT is first-line.

Imaging Appearance

  • Hyperdense collection in basal ganglia, lobar, thalamic, or cerebellar regions
  • Perihematomal edema, mass effect, midline shift
  • Intraventricular extension raises hydrocephalus risk

Clinical Significance

  • Rapid assessment determines ICU care, BP control, surgery consideration
  • Hematoma expansion risk highest in first hours

Symptoms

  • Sudden focal deficit, severe headache, vomiting, decreased consciousness

Diagnosis

  • Non-contrast head CT
  • Labs: renal/electrolytes for contrast planning or BP meds

Treatment

  • BP management, reverse anticoagulation, neurosurgical consult
  • Surgical evacuation for select lobar or cerebellar bleeds

Prognosis

  • Depends on volume, age, GCS; early care improves outcomes

What Should You Do?

  1. Activate stroke/ICH emergency pathway.
  2. Avoid anticoagulants/antiplatelets until cleared.
  3. Monitor neuro status closely.

Medical Disclaimer: Educational only; follow neurologist/neurosurgeon guidance.

Correlate with Lab Results

Doctors often check these blood tests when Intracerebral Hemorrhage (ICH) is found on imaging:

Related Imaging Terms

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Intracerebral Hemorrhage (ICH) on CT Scan: Meaning, Causes & Next Steps