Intracerebral Haematoma
Intracerebral Haematoma:
At a Glance
What it is: An intracerebral haematoma is a collection of blood within brain tissue, usually from a burst blood vessel or trauma.
How it affects people: It increases pressure in the skull and can damage brain cells, leading to sudden neurological symptoms.
Key concern: A large haematoma can be life-threatening and requires urgent care.
Diagnosis: Usually confirmed with an urgent CT scan or MRI scan.
Treatment options: Monitoring, medical management, or surgical treatment for intracerebral haematoma.
Outlook: With rapid diagnosis and treatment by an experienced neurosurgeon, many patients make a good recovery.
What is an Intracerebral Haematoma?
A intracerebral haematoma, also known as haemorrhagic stroke, is a type of brain bleed where blood collects directly within brain tissue. It is closely related to an intracerebral haemorrhage.
As blood builds up, it can create a mass effect, pushing on nearby brain tissues and increasing pressure within the skull.
This condition may follow a head injury or occur spontaneously, often linked to high blood pressure or weakened blood vessels. Because it disrupts blood flow and raises pressure inside the skull, it can cause symptoms similar to a stroke.
Types of Intracerebral Haematoma
Doctors may classify intracerebral haematomas in different ways:
Traumatic vs spontaneous: Traumatic haematomas occur after a head injury. Spontaneous cases may arise from high blood pressure, vascular abnormalities, or blood-thinning medication such as an oral anticoagulant.
Lobar vs deep: Lobar haematomas develop in the outer lobes of the brain, while deep haematomas occur in areas such as the basal ganglia or thalamus.
Primary vs secondary: Primary haematomas happen without another cause, while secondary ones result from conditions such as an aneurysm, arteriovenous malformations, tumour, or other vascular abnormalities.
Other classifications: In some cases, bleeding can spread into the ventricles, causing an intraventricular hemorrhage. Unlike a subdural haematoma, which lies beneath the dura mater, an intracerebral haematoma occurs within brain tissue itself.
This classification helps doctors decide on the most appropriate treatment.
Intracerebral Haematoma Symptoms
Common signs and symptoms
Sudden, severe headache
Nausea and vomiting
Weakness or numbness on one side of the body
Difficulty speaking or understanding speech
Balance or coordination problems
Seizures
Emergency / red flag symptoms
Loss of consciousness
Severe or rapidly worsening neurological decline
A severe headache with drowsiness or confusion
Call 999 immediately if these symptoms develop. Urgent assessment is vital.
Causes and Who Is at Risk
Causes of Intracerebral Haematoma
Bleeding into the brain may result from:
Trauma: The most common cause, especially after a head injury.
High blood pressure: Long-term hypertension weakens brain vessels.
Blood vessel problems: Such as aneurysms, subarachnoid haemorrhage, arteriovenous malformations (AVMs), or other abnormalities.
Blood disorders or medicines: Including clotting disorders or blood-thinning drugs such as an oral anticoagulant.
Cerebral amyloid angiopathy: In older adults, this condition can weaken vessels and cause spontaneous bleeding.
Health and Family Factors You Can’t Change
Older age (fragile blood vessels)
Vascular abnormalities present at birth
Family history of aneurysms, AVMs, or clotting conditions
Among all risk factors, uncontrolled high blood pressure is the leading preventable cause. Keeping blood pressure in a healthy range is one of the most effective ways to reduce risk.
Reducing Your Risk
You cannot always prevent an intracerebral haematoma, but you can lower your risk by:
Controlling high blood pressure
Wearing protective equipment to reduce the chance of head injury
Managing conditions such as diabetes and high cholesterol
Avoiding smoking and heavy alcohol use
Following medical advice on blood-thinning medication
Getting a Diagnosis
A diagnosis of intracerebral haematoma is usually made in hospital, often in an emergency. Tests include:
CT scan: The fastest way to detect bleeding.
MRI scan: Gives more detailed images of the haematoma and surrounding tissue.
Neurological examination: Doctors assess movement, reflexes, speech, and coordination.
These tests also help confirm whether the issue is an intracerebral haemorrhage or haematoma, guiding the right treatment.
Treatment Options for Intracerebral Haematoma
Intracerebral haematoma treatment options depend on the size, location, and cause of the haematoma.
Medical Management
Controlling blood pressure, stopping blood thinners, reducing swelling, and providing urgent medical care.
Ongoing Monitoring
Small haematomas may only need observation with repeat scans.
Surgical Intervention
Larger haematomas or those raising pressure may require surgery. This can involve a craniotomy (open operation) or, in some cases, minimally invasive such as tubular retractors.
Patients with severe bleeds are usually admitted to an intensive care unit, where close monitoring and urgent support are available.
Not every haematoma requires open brain surgery. In many cases, modern minimally invasive techniques can be used, helping to reduce recovery time. Mr Kailaya-Vasan, a neurovascular surgery specialist UK, works with expert neuroradiologists to provide safe, effective care. He is regarded as one of the best neurosurgeons in London for brain haematoma management, with extensive expertise in cranial surgery.
Living with an Intracerebral Haematoma
Recovery varies depending on the haematoma’s size, location, and the speed of treatment. Some patients make a full recovery, while others may have long-term effects. Rehabilitation is often part of recovery and may involve:
Physiotherapy for strength and movement
Speech and language therapy for communication problems
Occupational therapy for daily tasks
Psychological support for patients and families
Living with the impact of this condition can be challenging, but many patients improve with time, rehabilitation, and specialist follow-up. Support groups and rehabilitation programmes can provide guidance for both patients and families coping with recovery. These resources can help reduce isolation and improve confidence.
Book a consultation with Mr Ahilan Kailaya-Vasan
Receive a clear diagnosis and a tailored treatment plan from a leading consultant neurosurgeon. Appointments are available at top London hospitals, with remote options for international patients.
Seeking a second opinion?
If you have already received a diagnosis elsewhere, Mr Kailaya-Vasan can provide an independent review of your scans and medical notes, and explain the safest and most effective next steps.
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It is a collection of blood within brain tissue, often caused by a head injury or a ruptured vessel.
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Common symptoms include headache, weakness, speech problems, seizures, and in severe cases, loss of consciousness.
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The terms are often used interchangeably. Both describe bleeding within the brain, whether it is active bleeding or a collection of blood, and both require urgent medical care as part of a haemorrhagic stroke
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Through urgent scans such as a CT scan or MRI scan and a neurological assessment.
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Treatment may involve monitoring, medication, intensive medical care, or surgical treatment for intracerebral haematoma.
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Recovery depends on haematoma size, location, and treatment speed. Rehabilitation is often needed for long term recovery and independence.
FAQs about Intracerebral Haematoma
If you have any further questions, please get in touch.