Fast Five Quiz: Intracranial Hemorrhage

Helmi L. Lutsep, MD

Disclosures

May 01, 2019

The basal ganglia (also referred to as the basal nuclei) have the highest predilection for hypertensive ICH (40%-50%). The lobar regions account for 20%-50% of ICH. Sites less commonly associated with ICH include the thalamus (10%-15%), pons (5%-12%), and cerebellum (5%-10%). Other brainstem sites account for 1%-5% of ICH incidence.

Hypertensive ICH is caused by local small vessel changes. Chronic hypertension produces a small vessel vasculopathy characterized by lipohyalinosis, fibrinoid necrosis, and development of Charcot-Bouchard aneurysms. Each of these types of aneurysms affects penetrating arteries throughout the brain, including the lenticulostriate and thalamoperforator arteries, the paramedian branches of the basilar artery, the superior cerebellar arteries, and the anterior inferior cerebellar arteries.

For more on the effects of chronic hypertension on intracranial hemorrhage, read here.

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