What Are the Aftereffects of Intracerebral Hemorrhage?
Nov 05, 2019
Source: Cainiu Health
Dr. He Haochen
Introduction
What are the sequelae of intracerebral hemorrhage?
1. Dizziness—commonly occurs following cerebellar hemorrhage.
2. Hemiplegia—contralateral hemiplegia, hemisensory disturbance, and homonymous hemianopia corresponding to the site of hemorrhage.
3. Aphasia—may occur with left cerebral hemisphere hemorrhage, including motor aphasia, anomic aphasia, and sensory aphasia.
4. Epilepsy—seizures may develop during the early, middle, or late stages of intracerebral hemorrhage.
Intracerebral hemorrhage (ICH) refers to non-traumatic bleeding within the brain parenchyma. Its primary cause is cerebrovascular disease, closely associated with risk factors such as hyperlipidemia, diabetes mellitus, hypertension, vascular aging, and smoking. Patients with ICH often experience sudden onset during emotional agitation or physical exertion. The early mortality rate is high, and most survivors develop long-term sequelae. Common sequelae include dizziness, hemiplegia, aphasia, and epilepsy. Below, we detail these post-ICH sequelae.
What Are the Sequelae of Intracerebral Hemorrhage?
1. Dizziness
Dizziness is one of the common sequelae following ICH—particularly after cerebellar hemorrhage—and can be managed pharmacologically.
2. Hemiplegia
Hemiplegia is a frequent sequela of ICH. A large proportion of ICH cases are attributable to hypertension—termed hypertensive intracerebral hemorrhage—with common bleeding sites including the basal ganglia and thalamus. Hemorrhage in these regions disrupts functional areas, resulting in the classic “triad of contralateral deficits”: contralateral hemiplegia, contralateral sensory impairment, and homonymous hemianopia. These deficits often persist despite optimal treatment.
3. Aphasia
The language centers are typically located in the dominant (usually left) cerebral hemisphere. Left-hemispheric ICH may therefore lead to aphasia—including motor aphasia, nominal (anomia) aphasia, and sensory aphasia. Aphasia is frequently accompanied by facial palsy. Once the patient’s condition stabilizes, speech rehabilitation therapy is recommended. Facial palsy may be treated with acupuncture, physiotherapy, and low-frequency electrical stimulation.
4. Epilepsy
Epilepsy is another common sequela of ICH. Seizures may occur acutely during the early phase of ICH or manifest later—in the subacute or chronic stages. Therefore, prophylactic antiepileptic drug therapy is routinely initiated, typically continued for 1–2 years. However, many patients fail to adhere to this prolonged regimen and discontinue medication prematurely.
The above outlines the major sequelae of intracerebral hemorrhage: dizziness, hemiplegia, aphasia, and epilepsy. These sequelae profoundly impair patients’ quality of life and overall health. Most post-ICH deficits are irreversible. We therefore urge everyone to prioritize prevention of ICH in daily life to safeguard physical health.
