In this presentation we look at intracranial hemorrhage

Medical presentation

1. Intracranial Hemorrhage Overview, Pathophysiology, and Management

2. Etiology - Primary Causes: Hypertension, cerebral amyloid angiopathy - Secondary Causes: Trauma, coagulopathy, arteriovenous malformations, aneurysms, brain tumors

3. Pathophysiology 1. Initial Bleeding: Rupture of a blood vessel leads to blood accumulation. 2. Mass Effect: Increased intracranial pressure compresses brain structures. 3. Neurotoxic Effects: Hemoglobin breakdown induces edema and inflammation. 4. Secondary Injury: Ischemia due to reduced cerebral perfusion pressure.

4. Management 1. Initial Stabilization: - Manage airway, breathing, circulation. - Control hypertension: Target systolic BP <140 mmHg. - Reverse anticoagulation. 2. Medical Therapy: - Osmotic agents (e.g., Mannitol). - Anticonvulsants for seizures. 3. Surgical Intervention: - Indicated for large hematomas or midline shift. - Procedures: Craniotomy, stereotactic aspiration.

5. Latest Research - Prothrombin Complex Concentrates (PCCs) for rapid INR reversal. - Minimally Invasive Surgery (MIS) techniques, e.g., endoscopic evacuation. - Investigating neuroprotective agents such as Nrf2 activators.