Spontaneous intracerebral hemorrhage is a neurosurgical emergency. The most common cause is a chronically increased blood pressure. In young people with no risk factors, an underlying cause such as cavernous angioma, arteriovenous malformation or cerebral aneurysm should always be ruled out.
Depending on the neurological status of the patient, a surgical evacuation may be necessary, specially in cases with superficial hematomas.
In cases with intraventricular hemorrhage and hydrocephalus an external ventricular drainage may be necessary.
In cases with deep hemorrhage, it may be necessary to insert a sensor to monitor the intracranial pressure. In cases with severe intracranial hypertension, decompressive craniectomy might be required.
Treatments:
Microsurgical treatment of spontaneous intracerebral hemorrhage
Brain biopsy with neuronavigation or stereotactic frame
Invasive monitoring of intracranial pressure
Programmable and non-programmable ventriculoperitoneal shunt
Decompressive craniectomy
Cranioplasty with computer-designed implants