Intracerebral Hemorrhage (ICH) Treatment in Gurgaon, Haryana
What is an Intracerebral Hemorrhage?
An Intracerebral Hemorrhage is a type of stroke that occurs as a result of the rupture of an artery in the brain, leading to the leakage of blood out of the artery into the brain parenchyma. It can happen as a result of high blood pressure, trauma, abnormal connections of an artery in the brain- AVM/ aneurysm.
What are the Types of Intracerebral Hemorrhage?
Intracerebral hemorrhage (ICH) occurs when a blood vessel ruptures within the brain, causing bleeding into brain tissue. The type of hemorrhage usually depends on the location of the bleeding and the underlying cause. Each type has different symptoms, severity, and treatment approaches, so an accurate diagnosis through imaging like CT or MRI is essential.
- Lobar Hemorrhage: Bleeding occurs in the outer parts (lobes) of the brain, such as the frontal, parietal, temporal, or occipital lobes. It is often linked to amyloid angiopathy or high blood pressure.
- Deep (Basal Ganglia) Hemorrhage: Occurs in the deep structures of the brain, like the basal ganglia, thalamus, or internal capsule. This is usually caused by chronic hypertension.
- Brainstem Hemorrhage: Bleeding in the brainstem, which controls vital functions like breathing and heartbeat. This type is often severe and can be life-threatening.
- Cerebellar Hemorrhage: Bleeding occurs in the cerebellum, the part of the brain that controls balance and coordination. It can lead to dizziness, nausea, and difficulty walking.
- Intraventricular Hemorrhage (IVH): Blood enters the ventricles, the fluid-filled spaces in the brain. IVH can occur alone or along with other types of ICH and may increase pressure inside the brain.
What are the Symptoms of Intracerebral Hemorrhage?
Symptoms of intracerebral hemorrhage often start suddenly, with a severe headache and neurological changes. Weakness, confusion, speech or vision problems, balance issues, and seizures may develop progressively as the bleeding and swelling worsen. Immediate medical attention is critical to prevent further brain damage and improve outcomes.
- Sudden Severe Headache
- Weakness or Paralysis on One Side of the Body
- Loss of Consciousness or Confusion
- Difficulty Speaking, Vision Changes, and Balance Issues
- Seizures and Neurological Decline
What Causes Intracerebral Hemorrhage?
A combination of lifestyle factors, medical conditions, and sudden trauma can cause an intracerebral hemorrhage. Managing risk factors like high blood pressure, monitoring medications, and seeking care for head injuries are key preventive measures.
- Uncontrolled hypertension
- Fall, accident, or sports injury
- Anticoagulants (blood thinners) or blood-clotting conditions
- Abnormal tangles of blood vessels connecting arteries and veins
- Tumors, aneurysms, or infections
How is Intracerebral Hemorrhage Diagnosed?
Diagnosis of intracerebral hemorrhage involves a combination of imaging, lab tests, and careful clinical evaluation. Quick detection allows doctors to plan the right treatment, reduce complications, and improve recovery outcomes.
- A CT scan shows bleeding in the brain
- MRI provides more detailed images of brain tissue
- CT Angiography (CTA) and MR Angiography (MRA) detect abnormalities
- Blood tests check for clotting problems, platelet levels, and other abnormalities.
- Neurological exam to assess alertness, speech, vision, movement, and reflexes.
What are the Indications For Intracerebral Hemorrhage Treatment?
Not every small bleed may require immediate surgery, but an intracerebral hemorrhage is a medical emergency and should be evaluated by a doctor as soon as symptoms appear. If the patient notices Intracerebral Hemorrhage symptoms, book an appointment with the Intracerebral Hemorrhage specialist. The patient should seek urgent medical attention if any of the following situations occur:
- Large or Expanding Hematomas: If imaging shows a large or rapidly growing blood clot, it can compress brain tissue, increasing pressure inside the skull. Quick intervention is crucial to prevent permanent damage.
- Hemorrhage Causing Neurological Deficits: Sudden weakness, numbness, difficulty speaking, vision changes, or loss of coordination indicate the bleed is affecting brain function. Immediate medical care is required.
- Uncontrolled Bleeding Requiring Surgical Intervention: If bleeding continues despite initial management or medications, surgery may be necessary to remove the hematoma and relieve pressure.
- Patients with High Risk of Brain Herniation: Signs like extreme drowsiness, vomiting, severe headache, or uneven pupils may indicate dangerous brain swelling. Rapid medical evaluation is critical.
- Secondary Complications like Hydrocephalus: Blood can block fluid circulation in the brain, causing hydrocephalus (fluid buildup). Early detection and treatment prevent further neurological damage.
What are the Treatment Options For Intracerebral Hemorrhage?
The surgical treatment options for Intracerebral Hemorrhage (ICH), which is bleeding within the brain tissue itself, are primarily aimed at relieving pressure on the brain and, if possible, removing the blood clot (hematoma).
Decompression Surgery (Decompressive Craniectomy)
This procedure primarily manages pressure and swelling and may or may not include hematoma evacuation. To relieve dangerously high Intracranial Pressure (ICP) caused by the large hematoma and the resulting brain swelling (edema).
- The surgeon removes a large piece of the skull bone (a bone flap) and leaves it off temporarily.
- The dura mater (the protective covering of the brain) is usually opened and widened.
- This creates extra space, allowing the swollen brain to expand outward instead of being compressed within the skull.
- The bone flap is typically stored and reattached in a later procedure (cranioplasty) once the swelling has resolved.
Craniotomy With Open Surgery (Conventional Craniotomy)
This is a traditional, more invasive "open" surgery offering maximum visualisation for large or superficial clots, but it involves greater disruption to surrounding tissue than minimally invasive methods. To directly access and surgically remove the large blood clot. The surgeon creates a large bone flap in the skull (a craniotomy), which is temporarily removed. The dura mater is opened, and the overlying brain tissue may be incised or gently retracted to reach the hematoma. The clot is then directly visualised and removed using surgical instruments and suction. After clot removal and achieving hemostasis (stopping the bleeding), the bone flap is typically replaced and secured immediately.
Small Craniotomy With Evacuation
Similar to an open craniotomy, but the bone flap and the incision are kept as small as possible while still allowing direct visual access and removal of the hematoma. This often utilizes an operating microscope. The bone flap is usually replaced. This is a less invasive variation of the open approach, striving for a balance between clot clearance and minimizing brain tissue manipulation.
Simple Aspiration
A small hole (a burr hole) is drilled in the skull, and a catheter (a thin tube) or needle is inserted directly into the hematoma. The blood is then simply aspirated (suctioned) out. Often, a thrombolytic drug (clot-dissolving agent) may be injected into the cavity over several days to help liquefy the clot, with repeated aspiration attempts. This is a minimally invasive technique, often performed at the bedside. Still, the clot removal may be less complete than with open or endoscopic methods, and it may require multiple attempts.
Endoscopic Evacuation (Neuroendoscopy)
This minimally invasive technique provides excellent visualization of the clot cavity, which helps maximize clot removal and reduce potential damage to surrounding brain tissue. A small incision and burr hole are made. A neuroendoscope (a tube with a light source, camera, and working channels for instruments) is carefully guided through a minimal amount of brain tissue into the hematoma cavity. The clot is then removed under direct endoscopic visualization using suction, irrigation, and miniature instruments.
Stereotactic Aspiration
The aspiration device is often used to precisely guide the aspiration into the clot, which is often used for deep-seated hematomas. This technique relies on advanced imaging (CT or MRI) and a stereotactic frame or navigation system to precisely calculate the coordinates of the target (the center of the hematoma) and the safest trajectory. A small burr hole is made, and a catheter or aspiration needle is inserted with high precision to the predetermined location. As with simple aspiration, thrombolytic agents may be used to aid in liquefaction and removal over subsequent days. The key feature is the image-guided precision of the catheter placement, making it ideal for deep hemorrhages where visual guidance is impossible.
Clipping or Coiling Procedures
These are secondary preventative measures targeting the source of the bleed, not the evacuation of the resulting clot. However, they may be performed concurrently with clot evacuation if an aneurysm rupture is the cause of the ICH. These procedures are not for removing the ICH hematoma itself, but rather for treating the underlying cause of the hemorrhage, such as a ruptured aneurysm or Arteriovenous Malformation (AVM), to prevent re-bleeding.
A craniotomy is performed to access the ruptured artery. A small metal clip is placed across the neck (base) of the aneurysm to seal it off from the blood flow, preventing it from bleeding again.
This is a minimally invasive procedure where a catheter is threaded from an artery in the groin up to the aneurysm in the brain. Soft platinum coils are then deposited inside the aneurysm, causing the blood to clot and seal the aneurysm, thus preventing rupture or re-bleeding.
Why Choose Artemis Hospital For Intracerebral Hemorrhage Treatment?
Book an Appointment for Intracerebral Hemorrhage Treatment at Artemis Hospitals, Gurgaon. We have a dedicated team of neurosurgeons, neurologists, and critical care specialists experienced in managing complex brain hemorrhage cases. Supported by advanced neuroimaging technology, a 24/7 stroke unit, and state-of-the-art intensive care facilities, Artemis Hospitals ensures rapid diagnosis and timely intervention to minimize brain damage and improve recovery outcomes. Our multidisciplinary approach focuses on both emergency management and long-term neurological rehabilitation, providing comprehensive care under one roof. To book an appointment, call or WhatsApp on +91 98004 00498.
Frequently Asked Questions
How is an intracerebral hemorrhage different from an ischemic stroke?
An intracerebral hemorrhage occurs when a blood vessel ruptures and causes bleeding inside the brain, while an ischemic stroke happens when a blood clot blocks blood flow to part of the brain.
Who is at risk of developing ICH?
A person is at risk of intracerebral hemorrhage if they have chronic high blood pressure, take blood thinners, or have blood vessel abnormalities. Other risk factors include head injury, brain tumors, older age, etc., as all of these weaken blood vessels and increase the chance of brain bleeding.
What are the first warning signs of intracerebral hemorrhage?
In many cases, the first sign of an intracerebral hemorrhage is a sudden, severe headache, often described as the “worst headache of one’s life.”
What is the survival rate of intracerebral hemorrhage?
The amount of bleeding is really important when it comes to survival and recovery. Bigger bleeding usually means a higher chance of not surviving.
What is the difference between intracerebral and subarachnoid hemorrhage?
An intracerebral hemorrhage (ICH) happens when a blood vessel breaks within the brain tissue, resulting in bleeding inside the brain. Conversely, a subarachnoid hemorrhage (SAH) occurs when a blood vessel ruptures in the space between the brain and its outer layer (the subarachnoid space), causing bleeding around the brain instead of within it.
When is surgery required for ICH?
Doctors recommend surgery when bleeding threatens brain function or life, and immediate removal or decompression can improve outcomes.
Can an intracerebral hemorrhage recur after treatment?
Yes, bleeding in the brain can recur if high blood pressure or vascular abnormalities are left uncontrolled.
How long does recovery take after intracerebral hemorrhage treatment?
The recovery process varies based on the hemorrhage severity and the type of treatment received by the patients.
What kind of rehabilitation is needed after an intracerebral hemorrhage?
After intracerebral hemorrhage surgery, rehabilitation therapy is used to restore mobility so the patient can perform daily activities. This is carried out alongside speech and cognitive therapy for communication and memory.
What are the complications of Intracerebral Hemorrhage?
Complications from ICH can range from immediate life-threatening issues to long-term physical, cognitive, and emotional effects. Early medical care, careful monitoring, and rehabilitation are crucial to reduce these risks.
Who is the best doctor for intracerebral hemorrhage treatment near me?
At Artemis Hospital in Gurugram, the treatment for intracerebral hemorrhage is led by highly regarded specialists known for their expertise in this field. Our specialists have experience in neurosurgery and lead the hospital’s Neurosurgery and CyberKnife Centre.
Which is the best hospital for intracerebral hemorrhage treatment in Gurgaon?
Artemis Hospital is one of the best hospitals in Gurgaon for intracerebral hemorrhage treatment, offering advanced neurocritical care and expert neurosurgeons. The hospital has a dedicated 24/7 neuro ICU and specialists.
How can I book an emergency consultation for ICH treatment near me?
You can book an emergency consultation for ICH (Intracerebral Hemorrhage) treatment at Artemis Hospital by calling the emergency line: +91-124-4511 111.
Does Artemis Hospital have a 24/7 neuro ICU for brain hemorrhage patients?
Yes, Artemis Hospital in Gurugram has a 24/7 neuro ICU for brain hemorrhage patients. We offer immediate and comprehensive care for all types of brain hemorrhages, supported by a dedicated team of neurosurgeons and neurocritical care specialists.
Can I get rehabilitation support for brain hemorrhage recovery at Artemis Hospitals, Gurgaon?
Yes, you can get rehabilitation support at Artemis Hospitals. Our neurological rehabilitation for stroke patients includes advanced therapies such as functional electrical stimulation, gait training, and vestibular rehab, supported by a specialized team trained in hands-on approaches like PNF and Bobath techniques. Facilities also feature tilt tables, parallel bars, and assistive devices like walkers and crutches to enhance recovery.
