Hypertensive Intracerebral Hemorrhage

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Diagnosis & Tests

Neurologic examination may indicate increased intracerebral pressure, such as swelling of the optic nerve or changes in eye movement. Localized abnormalities in brain function are detected by observing abnormal reflexes or movement. The specific pattern of function changes may indicate the location of the problem within the brain. However, an image of the brain (CT scan or MRI) is necessary to prove the condition is due to intracerebral hemorrhage.

In order to diagnose the hemorrhage as a hypertensive hemorrhage, there must be some evidence of high blood pressure. Often the blood pressure is still very elevated when the patient is examined. Other times, there are other findings on examination or tests to suggest hypertension, such as abnormal blood vessels in the eyes or abnormal kidney function.

Tests to determine the amount and cause of bleeding include:

• CBC
• Platelet count
• Bleeding time
• Prothrombin time
• Partial thromboplastin time
• Liver function tests
• Kidney function tests
• Angiography of the head (if symptoms allow enough time to perform this test) -- reveals any aneurysm or arteriovenous malformation present

• Head CT scan (preferred if the hemorrhage began less than 48 hours earlier)
• Head MRI