neurologic disorders
Intracerebral Hemorrhage
Diagnosis of Intracerebral Hemorrhage
Neuroimaging Diagnosis of intracerebral hemorrhage is suggested by sudden onset of headache, focal neurologic deficits, and impaired consciousness, particularly in patients with risk factors. Intracerebral hemorrhage must be distinguished from Ischemic Stroke None Subarachnoid Hemorrhage (SAH) None Other causes of acute neurologic deficits (eg, Seizure Disorders , Blood glucose level should be measured at the bedside immediately. A complete blood count (CBC) and coagulation studies (international normalized ratio [INR], partial thromboplastin time [PTT], platelet count) are done. Immediate CT or MRI is necessary. Neuroimaging is usually diagnostic. If neuroimaging shows no hemorrhage but subarachnoid hemorrhage is suspected clinically, Lumbar Puncture (Spinal Tap) is necessary to look for xanthochromia. CT angiography, done within hours of bleeding onset, may show areas where contrast extravasates into the clot (spot sign); this finding indicates that bleeding is continuing and suggests that the hematoma will expand and the outcome will be poor. 