Materiały źródłowe

• #1 Intracranial Hematoma Diagnosis & Treatment – NYC | Columbia Neurosurgery in New York City

  https://www.neurosurgery.columbia.edu/patient-care/conditions/intracranial-hematoma

  An intracranial hematoma is a collection of clotted blood that forms inside the skull after an injury. […] Standard treatment may include expert monitoring and/or surgery for drainage. […] The diagnosis of an intracranial hematoma is made on the basis of a physical examination and imaging tests. […] For the imaging portion of the diagnosis, the doctor may order scans such as: […] Computed tomography scan, also called a CT or CAT scan: Uses a combination of X-rays and computer technology to produce images of horizontal and vertical cross-sections (sometimes called slices) of the body. […] Magnetic resonance imaging (MRI) scan: Uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.

• #2 Intracranial hematoma – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/intracranial-hematoma/symptoms-causes/syc-20356145

  An intracranial hematoma is a collection of blood within the skull. […] It usually requires immediate treatment. This might include surgery to remove the blood. […] An intracranial hematoma can be life-threatening and needs emergency treatment. […] All three types require medical attention as soon as symptoms appear. Prompt medical care may prevent permanent brain damage. […] An epidural hematoma that affects an artery in your brain can be deadly without prompt treatment. […] An intracerebral hematoma occurs when blood pools in the tissues of the brain. […] Activities that increase the risk of a bad head injury, such as riding a motorcycle or bicycle without a helmet, also raise the risk of an intracranial hematoma. […] The risk of a subdural hematoma increases with age. […] Some conditions also may increase the risk of having an intracerebral hematoma. […] To prevent or minimize a head injury that may cause an intracranial hematoma: Wear a helmet and make sure your kids wear helmets. […] All three types require medical attention as soon as symptoms appear.

• #3 Early diagnosis of traumatic intracranial hematomas

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6992895/

  Timing of the intervention for intracranial hematomas is critical for its success, specifically since expansion of the hemorrhage can result in debilitating and sometimes fatal outcomes. […] Infrascanner demonstrates high sensitivity (adults: 92.5% and children: 93%) and specificity (adults: 82.9% and children: 86.5%) in detecting intracranial hematomas 3.5mL in volume and 2.5cm from the surface of the brain. […] Diagnostic and treatment protocols mandate that a patient suffering from head trauma receive immediate medical assessment including a complete neurological examination. […] The gold standard imaging test is a computed tomography (CT) scan, which creates a series of cross-sectional x-ray images of the head and brain and can show bone fractures as well as the presence of hemorrhage, hematomas, contusions, brain tissue swelling, and tumors.

• #4 Intracranial hematoma – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/intracranial-hematoma/diagnosis-treatment/drc-20356149

  Diagnosing an intracranial hematoma can be a challenge because people with a head injury may seem fine at first. Healthcare professionals usually assume that bleeding inside the skull is the cause of a loss of consciousness after a head injury until proved otherwise. […] Imaging techniques are the best ways to determine the position and size of a hematoma. These include: […] CT is the most commonly used imaging scan to diagnose intracranial hematomas. […] MRI scan. This is done using magnetic field and radio waves to make computerized images. […] If there is concern about a possible aneurysm in the brain or other blood vessel issue, an angiogram can provide more information. This test uses X-rays and a special dye to produce pictures of the blood flow in the blood vessels in the brain.

• #5 Intracranial hematoma – Augusta HealthSearchClose SearchSearch IconSearch IconClose Search IconMobile Menu IconMobile Menu Close IconInstagramFacebookTwitterYoutube

  https://www.augustahealth.com/disease/intracranial-hematoma/

  Diagnosing an intracranial hematoma can be difficult because people with a head injury can seem fine. However, doctors generally assume that bleeding inside the skull is the cause of progressive loss of consciousness after a head injury until proved otherwise. […] Imaging techniques are the best ways to determine the position and size of a hematoma. These include: […] CT scan. This uses a sophisticated X-ray machine linked to a computer to produce detailed images of your brain. You lie still on a movable table that’s guided into what looks like a large doughnut where the images are taken. CT is the most commonly used imaging scan to diagnose intracranial hematomas. […] MRI scan. This is done using magnetic field and radio waves to make computerized images. During an MRI scan, you lie on a movable table that’s guided into a tube. […] Angiogram. If there is concern about a possible aneurysm in the brain or other blood vessel problem, an angiogram might be necessary to provide more information. This test uses X-rays and a special dye to produce pictures of the blood flow in the blood vessels in the brain.

• #6 Spontaneous intracerebral hemorrhage: Pathogenesis, clinical features, and diagnosis – UpToDate

  https://www.uptodate.com/contents/spontaneous-intracerebral-hemorrhage-pathogenesis-clinical-features-and-diagnosis

  Spontaneous intracerebral hemorrhage (ICH) is the second most common cause of stroke after ischemic stroke and is a substantial cause of morbidity and mortality. […] The pathogenesis, epidemiology, clinical features, and diagnosis of spontaneous (atraumatic) ICH will be reviewed here. […] Neuroimaging with brain computed tomography (CT) or magnetic resonance imaging (MRI) is mandatory to confirm the diagnosis of ICH and to exclude ischemic stroke and stroke mimics as possible causes. […] Initial evaluation—Clinical suspicion for ICH is based upon features such as acute onset of gradually worsening symptoms and increasing neurologic deficit, particularly if accompanied by severe headache, vomiting, severe hypertension, and decreased level of consciousness or coma. […] Subsequent imaging—Once ICH is confirmed by head CT or MRI, additional imaging is warranted in the event of clinical deterioration to evaluate for ICH expansion or rebleeding. […] Brain MRI with contrast is the preferred modality to help identify the underlying cause of ICH for most patients.

• #7 Intracranial hematoma – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/intracranial-hematoma/diagnosis-treatment/drc-20356149

  Diagnosing an intracranial hematoma can be a challenge because people with a head injury may seem fine at first. Healthcare professionals usually assume that bleeding inside the skull is the cause of a loss of consciousness after a head injury until proved otherwise. […] Imaging techniques are the best ways to determine the position and size of a hematoma. These include: […] CT is the most commonly used imaging scan to diagnose intracranial hematomas. […] MRI scan. This is done using magnetic field and radio waves to make computerized images. […] If there is concern about a possible aneurysm in the brain or other blood vessel issue, an angiogram can provide more information. This test uses X-rays and a special dye to produce pictures of the blood flow in the blood vessels in the brain.

• #8 Acute intracerebral haemorrhage: diagnosis and management | Practical Neurology

  https://pn.bmj.com/content/21/2/128

  Intracerebral haemorrhage (ICH) accounts for half of the disability-adjusted life years lost due to stroke worldwide. […] In this article, we address the important questions that neurologists face in the diagnosis and acute management of ICH, and focus on the supporting evidence and practical delivery for the main acute interventions. […] The initial diagnosis of acute blood in the brain substance is straightforward. Non-contrast brain CT is rapid, highly sensitive and specific for all forms of ICH, and widely available, so is considered the reference standard for ICH diagnosis. […] The CT scan should be assessed for ICH location, brain changes consistent with small vessel disease, the presence and degree of mass effect or midline shift, hydrocephalus, intraventricular extension and the size of the haematoma.

• #9 Intracranial Hematoma Diagnosis & Treatment – NYC | Columbia Neurosurgery in New York City

  https://www.neurosurgery.columbia.edu/patient-care/conditions/intracranial-hematoma

  An intracranial hematoma is a collection of clotted blood that forms inside the skull after an injury. […] Standard treatment may include expert monitoring and/or surgery for drainage. […] The diagnosis of an intracranial hematoma is made on the basis of a physical examination and imaging tests. […] For the imaging portion of the diagnosis, the doctor may order scans such as: […] Computed tomography scan, also called a CT or CAT scan: Uses a combination of X-rays and computer technology to produce images of horizontal and vertical cross-sections (sometimes called slices) of the body. […] Magnetic resonance imaging (MRI) scan: Uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.

• #10 Intracranial hemorrhage | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/intracranial-haemorrhage?lang=us

  CT scan is almost always the first imaging modality used to assess patients with suspected intracranial hemorrhage. Fortunately, acute blood is markedly hyperdense compared to brain parenchyma, and as such usually poses little difficulty in diagnosis (provided the amount of blood is large enough, and the scan is performed early). […] CT angiography (CTA) is increasingly used to assess for a vascular underlying cause, particularly in cases of subarachnoid hemorrhage, or intraparenchymal hemorrhage where something in the presentation, demographics of the patient, or location/appearance of bleed make a primary hemorrhage less likely. […] Similarly, CT venogram (CTV) can be used to reliably assess for patency of the dural venous sinuses. […] MRI is typically requested when an underlying abnormality is being sought, particularly when an underlying tumor is suspected. MRI of hemorrhage can pose some challenges in that the appearance of blood changes depending on the sequence and the time since the hemorrhage and the size and location of the bleed. […] Cerebral angiography is usually performed when a vascular abnormality is suspected and the CT/MR angiogram is either normal (and index of suspicion is high) or equivocal, or in cases where further delineation or treatment of an identified abnormality is required.

• #11

  https://www.saem.org/about-saem/academies-interest-groups-affiliates2/cdem/for-students/online-education/m4-curriculum/group-m4-neurology/intracranial-hemorrhage

  2. Describe the classical history and physical exam findings associated found with intracranial hemorrhage (ICH) […] The standard diagnostic pathway for SAH used to include CT followed by LP. This was because the sensitivity of CT, while reasonable, was still in the low 90s and missing a diagnosis of SAH is potentially lethal. […] However, improvements in CT scanning technology have led to improved sensitivities for SAH, particularly within the first 6 hours (99-100%). […] The head CT is the mainstay of diagnosis in ICH. On CT, acute bleeding appears hyperdense (whiter) relative to the surrounding tissues. […] If the CT or LP results are consistent with SAH, some form of angiography is necessary. […] Lumbar puncture is still an important part of the management in patients whose CT scans are delayed more than 6 hours after the onset of the headache.

• #12 The Radiology Assistant : Non-traumatic Intracranial Hemorrhage

  https://radiologyassistant.nl/neuroradiology/hemorrhage/non-traumatic-intracranial-hemorrhage

  Knowing the location of a hemorrhage is often the key to the differential diagnosis especially in non-traumatic bleeding. […] The first choice of imaging modality in a patient with a clinical suspicion of SAH is a non-enhanced CT scan (NECT). NECT is positive for SAH in 98% within 12 hours of onset. If the suspicion is strong, but the CT is negative, a lumbar puncture is performed to detect blood in the CSF. […] The presence of an intraventricular haematoma is considered a poor prognostic factor due to the obstruction to CSF with hydrocephalus and raised intracranial pressure. […] The differential diagnosis in a patient with an intracerebral hemorrhage however is much larger and also includes: Vascular malformations like arteriovenous malformation (AVM), dural arteriovenous fistulas (dAVF), aneurysms, cavernoma, DVA (very rare).

• #13

  https://www.saem.org/about-saem/academies-interest-groups-affiliates2/cdem/for-students/online-education/m4-curriculum/group-m4-neurology/intracranial-hemorrhage

  2. Describe the classical history and physical exam findings associated found with intracranial hemorrhage (ICH) […] The standard diagnostic pathway for SAH used to include CT followed by LP. This was because the sensitivity of CT, while reasonable, was still in the low 90s and missing a diagnosis of SAH is potentially lethal. […] However, improvements in CT scanning technology have led to improved sensitivities for SAH, particularly within the first 6 hours (99-100%). […] The head CT is the mainstay of diagnosis in ICH. On CT, acute bleeding appears hyperdense (whiter) relative to the surrounding tissues. […] If the CT or LP results are consistent with SAH, some form of angiography is necessary. […] Lumbar puncture is still an important part of the management in patients whose CT scans are delayed more than 6 hours after the onset of the headache.

• #14 Acute intracerebral haemorrhage: diagnosis and management | Practical Neurology

  https://pn.bmj.com/content/21/2/128

  Intracerebral haemorrhage (ICH) accounts for half of the disability-adjusted life years lost due to stroke worldwide. […] In this article, we address the important questions that neurologists face in the diagnosis and acute management of ICH, and focus on the supporting evidence and practical delivery for the main acute interventions. […] The initial diagnosis of acute blood in the brain substance is straightforward. Non-contrast brain CT is rapid, highly sensitive and specific for all forms of ICH, and widely available, so is considered the reference standard for ICH diagnosis. […] The CT scan should be assessed for ICH location, brain changes consistent with small vessel disease, the presence and degree of mass effect or midline shift, hydrocephalus, intraventricular extension and the size of the haematoma.

• #15 Intracranial Hemorrhage – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470242/

  Implement evidence-based protocols and proper evaluation, imaging, and monitoring protocols for timely diagnosis and management of intracranial hemorrhage. […] A non-contrast computed tomography (CT) scan of the head is the imaging modality unless additional modalities are indicated for further evaluation. […] If intracranial pressure (ICP) increases, a Cushing response (hypertension, bradycardia, and bradypnea) may occur as compensation. […] The characteristic imaging finding is a hyperdense extra-axial lens-shaped (biconvex) opacity. […] Acute subarachnoid hemorrhage is typically hyperdense on CT imaging. […] If the CT scan is negative and a strong suspicion of subarachnoid hemorrhage exists, a lumbar puncture (LP) should be considered. […] Identifying the cause of non-traumatic subarachnoid hemorrhage helps guide further treatment.

• #16 Intracranial hematoma – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/intracranial-hematoma/diagnosis-treatment/drc-20356149

  Diagnosing an intracranial hematoma can be a challenge because people with a head injury may seem fine at first. Healthcare professionals usually assume that bleeding inside the skull is the cause of a loss of consciousness after a head injury until proved otherwise. […] Imaging techniques are the best ways to determine the position and size of a hematoma. These include: […] CT is the most commonly used imaging scan to diagnose intracranial hematomas. […] MRI scan. This is done using magnetic field and radio waves to make computerized images. […] If there is concern about a possible aneurysm in the brain or other blood vessel issue, an angiogram can provide more information. This test uses X-rays and a special dye to produce pictures of the blood flow in the blood vessels in the brain.

• #17 Intracranial Hematoma Diagnosis & Treatment – NYC | Columbia Neurosurgery in New York City

  https://www.neurosurgery.columbia.edu/patient-care/conditions/intracranial-hematoma

  An intracranial hematoma is a collection of clotted blood that forms inside the skull after an injury. […] Standard treatment may include expert monitoring and/or surgery for drainage. […] The diagnosis of an intracranial hematoma is made on the basis of a physical examination and imaging tests. […] For the imaging portion of the diagnosis, the doctor may order scans such as: […] Computed tomography scan, also called a CT or CAT scan: Uses a combination of X-rays and computer technology to produce images of horizontal and vertical cross-sections (sometimes called slices) of the body. […] Magnetic resonance imaging (MRI) scan: Uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.

• #18 Diagnosis of intracerebral hemorrhage | STROKE MANUAL

  https://www.stroke-manual.com/intracerebral-hemorrhage-diagnosis/

  brain MRI is highly sensitive for detecting not only intracerebral hemorrhage but also possible underlying mass lesions, hemorrhagic transformation of ischemia, and cavernous malformations […] MRI can be used as the initial imaging method in the stroke program […] DSA is performed when CTA/MRA is negative or equivocal, and there is a reasonable suspicion of a bleeding source […] delayed repeat imaging with MRI+MRA after hematoma resolution may be used to detect an underlying lesion that may have been initially compressed or obscured by the hematoma.

• #19 Intracranial Hematomas – Injuries and Poisoning – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/injuries-and-poisoning/head-injuries/intracranial-hematomas

  Intracranial hematomas are accumulations of blood inside the skull, either within the brain or between the brain and the skull. […] Computed tomography or magnetic resonance imaging is used to detect an intracranial hematoma. […] Diagnosis of intracranial hematomas is usually based on results of computed tomography (CT). […] Early diagnosis of epidural hematomas is crucial and is usually based on results of computed tomography (CT). […] Computed tomography (CT) can detect acute, subacute, and many chronic subdural hematomas. Magnetic resonance imaging (MRI) is particularly accurate for diagnosis of chronic subdural hematomas. […] Intracerebral hematomas are common after a severe head injury. […] Computed tomography (CT) or magnetic resonance imaging (MRI) can detect intracerebral hematomas.

• #20 Intracranial hemorrhage | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/intracranial-haemorrhage?lang=us

  CT scan is almost always the first imaging modality used to assess patients with suspected intracranial hemorrhage. Fortunately, acute blood is markedly hyperdense compared to brain parenchyma, and as such usually poses little difficulty in diagnosis (provided the amount of blood is large enough, and the scan is performed early). […] CT angiography (CTA) is increasingly used to assess for a vascular underlying cause, particularly in cases of subarachnoid hemorrhage, or intraparenchymal hemorrhage where something in the presentation, demographics of the patient, or location/appearance of bleed make a primary hemorrhage less likely. […] Similarly, CT venogram (CTV) can be used to reliably assess for patency of the dural venous sinuses. […] MRI is typically requested when an underlying abnormality is being sought, particularly when an underlying tumor is suspected. MRI of hemorrhage can pose some challenges in that the appearance of blood changes depending on the sequence and the time since the hemorrhage and the size and location of the bleed. […] Cerebral angiography is usually performed when a vascular abnormality is suspected and the CT/MR angiogram is either normal (and index of suspicion is high) or equivocal, or in cases where further delineation or treatment of an identified abnormality is required.

• #21 Spontaneous intracerebral hemorrhage: Pathogenesis, clinical features, and diagnosis – UpToDate

  https://www.uptodate.com/contents/spontaneous-intracerebral-hemorrhage-pathogenesis-clinical-features-and-diagnosis

  Spontaneous intracerebral hemorrhage (ICH) is the second most common cause of stroke after ischemic stroke and is a substantial cause of morbidity and mortality. […] The pathogenesis, epidemiology, clinical features, and diagnosis of spontaneous (atraumatic) ICH will be reviewed here. […] Neuroimaging with brain computed tomography (CT) or magnetic resonance imaging (MRI) is mandatory to confirm the diagnosis of ICH and to exclude ischemic stroke and stroke mimics as possible causes. […] Initial evaluation—Clinical suspicion for ICH is based upon features such as acute onset of gradually worsening symptoms and increasing neurologic deficit, particularly if accompanied by severe headache, vomiting, severe hypertension, and decreased level of consciousness or coma. […] Subsequent imaging—Once ICH is confirmed by head CT or MRI, additional imaging is warranted in the event of clinical deterioration to evaluate for ICH expansion or rebleeding. […] Brain MRI with contrast is the preferred modality to help identify the underlying cause of ICH for most patients.

• #22 Intracranial hematoma – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/intracranial-hematoma/diagnosis-treatment/drc-20356149

  Diagnosing an intracranial hematoma can be a challenge because people with a head injury may seem fine at first. Healthcare professionals usually assume that bleeding inside the skull is the cause of a loss of consciousness after a head injury until proved otherwise. […] Imaging techniques are the best ways to determine the position and size of a hematoma. These include: […] CT is the most commonly used imaging scan to diagnose intracranial hematomas. […] MRI scan. This is done using magnetic field and radio waves to make computerized images. […] If there is concern about a possible aneurysm in the brain or other blood vessel issue, an angiogram can provide more information. This test uses X-rays and a special dye to produce pictures of the blood flow in the blood vessels in the brain.

• #23 Intracranial hemorrhage | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/intracranial-haemorrhage?lang=us

  CT scan is almost always the first imaging modality used to assess patients with suspected intracranial hemorrhage. Fortunately, acute blood is markedly hyperdense compared to brain parenchyma, and as such usually poses little difficulty in diagnosis (provided the amount of blood is large enough, and the scan is performed early). […] CT angiography (CTA) is increasingly used to assess for a vascular underlying cause, particularly in cases of subarachnoid hemorrhage, or intraparenchymal hemorrhage where something in the presentation, demographics of the patient, or location/appearance of bleed make a primary hemorrhage less likely. […] Similarly, CT venogram (CTV) can be used to reliably assess for patency of the dural venous sinuses. […] MRI is typically requested when an underlying abnormality is being sought, particularly when an underlying tumor is suspected. MRI of hemorrhage can pose some challenges in that the appearance of blood changes depending on the sequence and the time since the hemorrhage and the size and location of the bleed. […] Cerebral angiography is usually performed when a vascular abnormality is suspected and the CT/MR angiogram is either normal (and index of suspicion is high) or equivocal, or in cases where further delineation or treatment of an identified abnormality is required.

• #24

  https://www.advocatehealth.com/health-services/brain-spine-institute/intracranial-hemorrhage

  Brain hemorrhage diagnosis […] To make a brain hemorrhage diagnosis, your doctor will first ask about your brain bleed symptoms. Next, theyll work to locate the source of the bleeding. To do this, your doctor may order a CT scan, an MRI or one of the following tests: […] A lumbar puncture: Also known as a spinal tap, a lumbar puncture is another way to make a brain bleed diagnosis. […] Computed tomography angiography (CTA): During a CTA test, dye is injected directly into the bloodstream. This dye makes it easy to see the arteries in your brain on a CT scan. […] Angiogram: During an angiogram, a catheter is inserted into an artery and threaded through the circulatory system up to the brain. A dye is then injected through the catheter. This dye makes blood flow easier to see on X-rays. […] Cerebrospinal fluid exam: Evidence of blood in this fluid may indicate bleeding.

• #25 Intracerebral hemorrhage – Wikipedia

  https://en.wikipedia.org/wiki/Intracerebral_hemorrhage

  Both computed tomography angiography (CTA) and magnetic resonance angiography (MRA) have been proved to be effective in diagnosing intracranial vascular malformations after ICH. […] Diagnosis is typically by CT scan. […] Intraparenchymal hemorrhage can be recognized on CT scans because blood appears brighter than other tissue and is separated from the inner table of the skull by brain tissue. […] Apart from CT scans, haematoma progression of intracerebral haemorrhage can be monitored using transcranial ultrasound.

• #26 Diagnosis of intracerebral hemorrhage | STROKE MANUAL

  https://www.stroke-manual.com/intracerebral-hemorrhage-diagnosis/

  brain MRI is highly sensitive for detecting not only intracerebral hemorrhage but also possible underlying mass lesions, hemorrhagic transformation of ischemia, and cavernous malformations […] MRI can be used as the initial imaging method in the stroke program […] DSA is performed when CTA/MRA is negative or equivocal, and there is a reasonable suspicion of a bleeding source […] delayed repeat imaging with MRI+MRA after hematoma resolution may be used to detect an underlying lesion that may have been initially compressed or obscured by the hematoma.

• #27 Intracranial hemorrhage | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/intracranial-haemorrhage?lang=us

  CT scan is almost always the first imaging modality used to assess patients with suspected intracranial hemorrhage. Fortunately, acute blood is markedly hyperdense compared to brain parenchyma, and as such usually poses little difficulty in diagnosis (provided the amount of blood is large enough, and the scan is performed early). […] CT angiography (CTA) is increasingly used to assess for a vascular underlying cause, particularly in cases of subarachnoid hemorrhage, or intraparenchymal hemorrhage where something in the presentation, demographics of the patient, or location/appearance of bleed make a primary hemorrhage less likely. […] Similarly, CT venogram (CTV) can be used to reliably assess for patency of the dural venous sinuses. […] MRI is typically requested when an underlying abnormality is being sought, particularly when an underlying tumor is suspected. MRI of hemorrhage can pose some challenges in that the appearance of blood changes depending on the sequence and the time since the hemorrhage and the size and location of the bleed. […] Cerebral angiography is usually performed when a vascular abnormality is suspected and the CT/MR angiogram is either normal (and index of suspicion is high) or equivocal, or in cases where further delineation or treatment of an identified abnormality is required.

• #28

  https://www.saem.org/about-saem/academies-interest-groups-affiliates2/cdem/for-students/online-education/m4-curriculum/group-m4-neurology/intracranial-hemorrhage

  2. Describe the classical history and physical exam findings associated found with intracranial hemorrhage (ICH) […] The standard diagnostic pathway for SAH used to include CT followed by LP. This was because the sensitivity of CT, while reasonable, was still in the low 90s and missing a diagnosis of SAH is potentially lethal. […] However, improvements in CT scanning technology have led to improved sensitivities for SAH, particularly within the first 6 hours (99-100%). […] The head CT is the mainstay of diagnosis in ICH. On CT, acute bleeding appears hyperdense (whiter) relative to the surrounding tissues. […] If the CT or LP results are consistent with SAH, some form of angiography is necessary. […] Lumbar puncture is still an important part of the management in patients whose CT scans are delayed more than 6 hours after the onset of the headache.

• #29 The Radiology Assistant : Non-traumatic Intracranial Hemorrhage

  https://radiologyassistant.nl/neuroradiology/hemorrhage/non-traumatic-intracranial-hemorrhage

  Hypertensive intracranial haemorrhage together with CAA make up 80% of the causes of intraparenchymal hematomas. Think of CAA if you see multiple peripheral or lobar haemorrhages in an elderly patient. […] The images show a subarachnoid hemorrhage from a left cerebri media aneurysm. […] In a SAH we usually will find an aneurysm with CTA. If the CTA does not show an aneurysm we usually continue with a DSA because it has a higher sensitivity.

• #30 Brain hemorrhage: Causes, symptoms, and treatments

  https://www.medicalnewstoday.com/articles/317080

  A brain hemorrhage usually causes very noticeable symptoms and signs, and doctors usually carry out diagnostic testing urgently to help identify the size and location of the bleed and to guide prompt treatment steps. […] Testing options include: […] Doctors typically perform a brain CT scan immediately, as it is quick and can easily identify bleeding. They may order an MRI later, when a person is in a more stable condition, because an MRI takes longer than a CT scan. […] During cerebral angiography, a doctor injects a dye into the bloodstream and then takes X-ray images of the brain, with the dye highlighting abnormally shaped blood vessels in or near the brain. A doctor may recommend this method when a person is in a stable condition. […] This is also known as a spinal tap, in which a doctor removes spinal fluid through a hollow needle for testing. Doctors less commonly use this method to diagnose brain hemorrhage.

• #31

  https://www.advocatehealth.com/health-services/brain-spine-institute/intracranial-hemorrhage

  Brain hemorrhage diagnosis […] To make a brain hemorrhage diagnosis, your doctor will first ask about your brain bleed symptoms. Next, theyll work to locate the source of the bleeding. To do this, your doctor may order a CT scan, an MRI or one of the following tests: […] A lumbar puncture: Also known as a spinal tap, a lumbar puncture is another way to make a brain bleed diagnosis. […] Computed tomography angiography (CTA): During a CTA test, dye is injected directly into the bloodstream. This dye makes it easy to see the arteries in your brain on a CT scan. […] Angiogram: During an angiogram, a catheter is inserted into an artery and threaded through the circulatory system up to the brain. A dye is then injected through the catheter. This dye makes blood flow easier to see on X-rays. […] Cerebrospinal fluid exam: Evidence of blood in this fluid may indicate bleeding.

• #32 Intracranial Hemorrhage – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470242/

  Implement evidence-based protocols and proper evaluation, imaging, and monitoring protocols for timely diagnosis and management of intracranial hemorrhage. […] A non-contrast computed tomography (CT) scan of the head is the imaging modality unless additional modalities are indicated for further evaluation. […] If intracranial pressure (ICP) increases, a Cushing response (hypertension, bradycardia, and bradypnea) may occur as compensation. […] The characteristic imaging finding is a hyperdense extra-axial lens-shaped (biconvex) opacity. […] Acute subarachnoid hemorrhage is typically hyperdense on CT imaging. […] If the CT scan is negative and a strong suspicion of subarachnoid hemorrhage exists, a lumbar puncture (LP) should be considered. […] Identifying the cause of non-traumatic subarachnoid hemorrhage helps guide further treatment.

• #33 The Radiology Assistant : Non-traumatic Intracranial Hemorrhage

  https://radiologyassistant.nl/neuroradiology/hemorrhage/non-traumatic-intracranial-hemorrhage

  Knowing the location of a hemorrhage is often the key to the differential diagnosis especially in non-traumatic bleeding. […] The first choice of imaging modality in a patient with a clinical suspicion of SAH is a non-enhanced CT scan (NECT). NECT is positive for SAH in 98% within 12 hours of onset. If the suspicion is strong, but the CT is negative, a lumbar puncture is performed to detect blood in the CSF. […] The presence of an intraventricular haematoma is considered a poor prognostic factor due to the obstruction to CSF with hydrocephalus and raised intracranial pressure. […] The differential diagnosis in a patient with an intracerebral hemorrhage however is much larger and also includes: Vascular malformations like arteriovenous malformation (AVM), dural arteriovenous fistulas (dAVF), aneurysms, cavernoma, DVA (very rare).

• #34

  https://www.saem.org/about-saem/academies-interest-groups-affiliates2/cdem/for-students/online-education/m4-curriculum/group-m4-neurology/intracranial-hemorrhage

  2. Describe the classical history and physical exam findings associated found with intracranial hemorrhage (ICH) […] The standard diagnostic pathway for SAH used to include CT followed by LP. This was because the sensitivity of CT, while reasonable, was still in the low 90s and missing a diagnosis of SAH is potentially lethal. […] However, improvements in CT scanning technology have led to improved sensitivities for SAH, particularly within the first 6 hours (99-100%). […] The head CT is the mainstay of diagnosis in ICH. On CT, acute bleeding appears hyperdense (whiter) relative to the surrounding tissues. […] If the CT or LP results are consistent with SAH, some form of angiography is necessary. […] Lumbar puncture is still an important part of the management in patients whose CT scans are delayed more than 6 hours after the onset of the headache.

• #35 Intracerebral Hemorrhage – Neurologic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/neurologic-disorders/stroke/intracerebral-hemorrhage

  Diagnosis of intracerebral hemorrhage is suggested by sudden onset of headache, focal neurologic deficits, and impaired consciousness, particularly in patients with risk factors. […] Immediate CT or MRI is necessary. Neuroimaging is usually diagnostic. If neuroimaging shows no hemorrhage but subarachnoid hemorrhage is suspected clinically, lumbar puncture is necessary to look for xanthochromia. […] CT angiography, done within hours of bleeding onset, may show areas where contrast extravasates into the clot (spot sign); this finding indicates that bleeding is continuing and suggests that the hematoma will expand and the outcome will be poor.

• #36 Brain Hemorrhage | Intracranial Hemorrhage – Causes, Symptoms, Diagnosis, Treatment & Prevention

  https://www.medindia.net/health/conditions/brain-hemorrhage.htm

  Spinal tap or lumbar puncture: Enables examination of the cerebrospinal fluid that surrounds the brain. Useful to diagnose subarachnoid hemorrhage. […] Infrared spectroscopy: Furnishes reasonable sensitivity and specificity for the detection of intracranial lesions in a short time when the patient is critically ill and requires urgent surgical intervention. […] Blood tests to evaluate the coagulation profile (blood clotting ability) of the patient. […] Glasgow coma scale (GCS) or National Institutes of Health Stroke Scale (NIHSS) helps assess the level of consciousness or neurological status.

• #37 Epidural hematoma – Wikipedia

  https://en.wikipedia.org/wiki/Epidural_hematoma

  Diagnosis is typically by a CT scan or MRI. […] MRIs have greater sensitivity and should be used if there is a high suspicion of epidural hematoma and a negative CT scan. […] Epidural hematomas usually appear convex in shape because their expansion stops at the skull’s sutures, where the dura mater is tightly attached to the skull. […] Most people also have a skull fracture. […] CT scans reveal subdural or epidural hematomas in 20% of unconscious people. […] In the hallmark of epidural hematoma, people may regain consciousness and appear completely normal during what is called a lucid interval, only to descend suddenly and rapidly into unconsciousness later. This lucid interval, which depends on the extent of the injury, is a key to diagnosing an epidural hematoma.

• #38 Intracranial Hematomas – Injuries and Poisoning – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/injuries-and-poisoning/head-injuries/intracranial-hematomas

  Intracranial hematomas are accumulations of blood inside the skull, either within the brain or between the brain and the skull. […] Computed tomography or magnetic resonance imaging is used to detect an intracranial hematoma. […] Diagnosis of intracranial hematomas is usually based on results of computed tomography (CT). […] Early diagnosis of epidural hematomas is crucial and is usually based on results of computed tomography (CT). […] Computed tomography (CT) can detect acute, subacute, and many chronic subdural hematomas. Magnetic resonance imaging (MRI) is particularly accurate for diagnosis of chronic subdural hematomas. […] Intracerebral hematomas are common after a severe head injury. […] Computed tomography (CT) or magnetic resonance imaging (MRI) can detect intracerebral hematomas.

• #39 Epidural hematoma – Wikipedia

  https://en.wikipedia.org/wiki/Epidural_hematoma

  Diagnosis is typically by a CT scan or MRI. […] MRIs have greater sensitivity and should be used if there is a high suspicion of epidural hematoma and a negative CT scan. […] Epidural hematomas usually appear convex in shape because their expansion stops at the skull’s sutures, where the dura mater is tightly attached to the skull. […] Most people also have a skull fracture. […] CT scans reveal subdural or epidural hematomas in 20% of unconscious people. […] In the hallmark of epidural hematoma, people may regain consciousness and appear completely normal during what is called a lucid interval, only to descend suddenly and rapidly into unconsciousness later. This lucid interval, which depends on the extent of the injury, is a key to diagnosing an epidural hematoma.

• #40 Epidural hematoma – Wikipedia

  https://en.wikipedia.org/wiki/Epidural_hematoma

  Diagnosis is typically by a CT scan or MRI. […] MRIs have greater sensitivity and should be used if there is a high suspicion of epidural hematoma and a negative CT scan. […] Epidural hematomas usually appear convex in shape because their expansion stops at the skull’s sutures, where the dura mater is tightly attached to the skull. […] Most people also have a skull fracture. […] CT scans reveal subdural or epidural hematomas in 20% of unconscious people. […] In the hallmark of epidural hematoma, people may regain consciousness and appear completely normal during what is called a lucid interval, only to descend suddenly and rapidly into unconsciousness later. This lucid interval, which depends on the extent of the injury, is a key to diagnosing an epidural hematoma.

• #41 Epidural hematoma – Wikipedia

  https://en.wikipedia.org/wiki/Epidural_hematoma

  Diagnosis is typically by a CT scan or MRI. […] MRIs have greater sensitivity and should be used if there is a high suspicion of epidural hematoma and a negative CT scan. […] Epidural hematomas usually appear convex in shape because their expansion stops at the skull’s sutures, where the dura mater is tightly attached to the skull. […] Most people also have a skull fracture. […] CT scans reveal subdural or epidural hematomas in 20% of unconscious people. […] In the hallmark of epidural hematoma, people may regain consciousness and appear completely normal during what is called a lucid interval, only to descend suddenly and rapidly into unconsciousness later. This lucid interval, which depends on the extent of the injury, is a key to diagnosing an epidural hematoma.

• #42 Subdural Hematoma: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/21183-subdural-hematoma

  A subdural hematoma is a type of bleeding inside your head. It happens when blood collects under the dura mater, one of the layers of tissue that protect your brain. It most often happens from a head injury and can be fatal. […] A healthcare provider will do a thorough physical and neurological exam. Theyll ask about: Your symptoms. How and when your head injury happened. Underlying health conditions you have. Medications you take. […] If the provider thinks you may have a subdural hematoma, theyll order an imaging test of your head. This may be a computed tomography (CT) scan and/or a magnetic resonance imaging (MRI) scan. These tests allow providers to see clear pictures of your brain and determine the location and amount of bleeding. They can also show other head and neck injuries.

• #43

  https://www.nhs.uk/conditions/subdural-haematoma/diagnosis/

  Subdural haematomas are diagnosed based on a person’s medical history, symptoms and the results of a brain scan. […] Most people with a suspected subdural haematoma will have a CT scan to confirm the diagnosis. […] A CT scan uses X-rays and a computer to create detailed images of the inside of your body. […] It can show whether any blood has collected between your skull and your brain. […] In a few cases, an MRI scan may be used to check for a subdural haematoma instead.

• #44

  https://www.ijcmph.com/index.php/ijcmph/article/view/3625

  Subdural hematoma is diagnosed using CT or MRI imaging. […] Acute subdural hematoma is an emergency and requires prompt diagnosis using CT most of the time, and management requires surgery as well as reversal of anticoagulants. […] Subdural hematoma are clinical emergencies that require immediate and rapid management to prevent significant morbidity and mortality. […] Controlling intracranial pressure is an important factor for predicting the outcomes of subdural hematoma, and should thus be continuously monitored and corrected.

• #45 Intracranial Hematomas – Injuries and Poisoning – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/injuries-and-poisoning/head-injuries/intracranial-hematomas

  Intracranial hematomas are accumulations of blood inside the skull, either within the brain or between the brain and the skull. […] Computed tomography or magnetic resonance imaging is used to detect an intracranial hematoma. […] Diagnosis of intracranial hematomas is usually based on results of computed tomography (CT). […] Early diagnosis of epidural hematomas is crucial and is usually based on results of computed tomography (CT). […] Computed tomography (CT) can detect acute, subacute, and many chronic subdural hematomas. Magnetic resonance imaging (MRI) is particularly accurate for diagnosis of chronic subdural hematomas. […] Intracerebral hematomas are common after a severe head injury. […] Computed tomography (CT) or magnetic resonance imaging (MRI) can detect intracerebral hematomas.

• #46 Subdural Hematoma: Causes, Types, Symptoms, Risks & Recovery

  https://www.webmd.com/brain/subdural-hematoma-symptoms-causes-treatments

  Subdural hematomas are usually caused by a head injury from a fall, motor vehicle collision, or an assault. […] People who get medical attention after a head injury often undergo head imaging, usually with computed tomography (CT scan) or magnetic resonance imaging (MRI scan). These tests create images of the interior of the skull, usually detecting any subdural hematoma present. […] Rarely, angiography may be used to diagnose subdural hematoma. […] Treatment of subdural hematomas depends on their severity. Treatment can range from watchful waiting to brain surgery. […] In small subdural hematomas with mild symptoms, doctors may recommend no specific treatment other than observation. […] People with severe subdural hematomas are often seriously ill, requiring machine-supported breathing and other forms of life support.

• #47 Intracranial hematoma – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/intracranial-hematoma/symptoms-causes/syc-20356145

  An intracranial hematoma is a collection of blood within the skull. […] It usually requires immediate treatment. This might include surgery to remove the blood. […] An intracranial hematoma can be life-threatening and needs emergency treatment. […] All three types require medical attention as soon as symptoms appear. Prompt medical care may prevent permanent brain damage. […] An epidural hematoma that affects an artery in your brain can be deadly without prompt treatment. […] An intracerebral hematoma occurs when blood pools in the tissues of the brain. […] Activities that increase the risk of a bad head injury, such as riding a motorcycle or bicycle without a helmet, also raise the risk of an intracranial hematoma. […] The risk of a subdural hematoma increases with age. […] Some conditions also may increase the risk of having an intracerebral hematoma. […] To prevent or minimize a head injury that may cause an intracranial hematoma: Wear a helmet and make sure your kids wear helmets. […] All three types require medical attention as soon as symptoms appear.

• #48 Intracranial Hematomas – Injuries and Poisoning – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/injuries-and-poisoning/head-injuries/intracranial-hematomas

  Intracranial hematomas are accumulations of blood inside the skull, either within the brain or between the brain and the skull. […] Computed tomography or magnetic resonance imaging is used to detect an intracranial hematoma. […] Diagnosis of intracranial hematomas is usually based on results of computed tomography (CT). […] Early diagnosis of epidural hematomas is crucial and is usually based on results of computed tomography (CT). […] Computed tomography (CT) can detect acute, subacute, and many chronic subdural hematomas. Magnetic resonance imaging (MRI) is particularly accurate for diagnosis of chronic subdural hematomas. […] Intracerebral hematomas are common after a severe head injury. […] Computed tomography (CT) or magnetic resonance imaging (MRI) can detect intracerebral hematomas.

• #49 Acute intracerebral haemorrhage: diagnosis and management | Practical Neurology

  https://pn.bmj.com/content/21/2/128

  Intracerebral haemorrhage (ICH) accounts for half of the disability-adjusted life years lost due to stroke worldwide. […] In this article, we address the important questions that neurologists face in the diagnosis and acute management of ICH, and focus on the supporting evidence and practical delivery for the main acute interventions. […] The initial diagnosis of acute blood in the brain substance is straightforward. Non-contrast brain CT is rapid, highly sensitive and specific for all forms of ICH, and widely available, so is considered the reference standard for ICH diagnosis. […] The CT scan should be assessed for ICH location, brain changes consistent with small vessel disease, the presence and degree of mass effect or midline shift, hydrocephalus, intraventricular extension and the size of the haematoma.

• #50 Diagnosis of intracerebral hemorrhage | STROKE MANUAL

  https://www.stroke-manual.com/intracerebral-hemorrhage-diagnosis/

  for patients presenting with stroke-like symptoms, rapid neuroimaging using CT or MRI is recommended to confirm the diagnosis of spontaneous intracerebral hemorrhage (ICH) […] the detection of intracerebral bleeding itself by imaging methods is easy; the diagnostic evaluation is focused on determining the underlying etiology […] computerized tomography (CT) is performed immediately following stabilization to confirm diagnosis, location, and extent of hemorrhage […] baseline examination objectives: detect and localize the hematoma, assess its type, volume, probable etiology, risk of complications, assess the prognosis […] there are several NCCT predictors of hematoma expansion and unfavorable outcome in acute ICH […] diagnosing small brainstem hematomas is challenging, especially when discoloration has already begun

• #51 Intracranial Hematomas – Injuries and Poisoning – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/injuries-and-poisoning/head-injuries/intracranial-hematomas

  Intracranial hematomas are accumulations of blood inside the skull, either within the brain or between the brain and the skull. […] Computed tomography or magnetic resonance imaging is used to detect an intracranial hematoma. […] Diagnosis of intracranial hematomas is usually based on results of computed tomography (CT). […] Early diagnosis of epidural hematomas is crucial and is usually based on results of computed tomography (CT). […] Computed tomography (CT) can detect acute, subacute, and many chronic subdural hematomas. Magnetic resonance imaging (MRI) is particularly accurate for diagnosis of chronic subdural hematomas. […] Intracerebral hematomas are common after a severe head injury. […] Computed tomography (CT) or magnetic resonance imaging (MRI) can detect intracerebral hematomas.

• #52 Intracerebral hemorrhage (ICH) – EMCrit Project

  https://emcrit.org/ibcc/ich/

  Hematoma expansion will often occur within 6-24 hours (or later in anticoagulated patients). […] The spot sign reveals leakage of contrast into the hematoma (predicting expansion with 51% sensitivity and 85% specificity). […] Cerebral vein thrombosis with hemorrhagic transformation is an important cause of ICH, because this requires specific management. […] CT scan with CT angiography is often the initial investigation. […] In patients with spontaneous intraventricular hemorrhage and no detectable parenchymal hemorrhage, catheter intra-arterial digital subtraction angiography is recommended to exclude a vascular cause.

• #53 GFAP point-of-care measurement for prehospital diagnosis of intracranial hemorrhage in acute coma | Critical Care | Full Text

  https://ccforum.biomedcentral.com/articles/10.1186/s13054-024-04892-5

  Prehospital triage and treatment of patients with acute coma is challenging for rescue services, as the underlying pathological conditions are highly heterogenous. Recently, glial fibrillary acidic protein (GFAP) has been identified as a biomarker of intracranial hemorrhage. The aim of this prospective study was to test whether prehospital GFAP measurements on a point-of-care device have the potential to rapidly differentiate intracranial hemorrhage from other causes of acute coma. […] Increased GFAP plasma concentrations in patients with acute coma identify intracranial hemorrhage with high diagnostic accuracy. Prehospital GFAP measurements on a point-of-care platform allow rapid stratification according to the underlying cause of coma by rescue services. This could have major impact on triage and management of these critically ill patients.

• #54 GFAP point-of-care measurement for prehospital diagnosis of intracranial hemorrhage in acute coma | Critical Care | Full Text

  https://ccforum.biomedcentral.com/articles/10.1186/s13054-024-04892-5

  Our study demonstrated that prehospital plasma GFAP measurements on a point-of-care platform identify intracranial hemorrhage as the underlying cause of acute coma with high diagnostic accuracy. This allows rapid diagnosis-specific stratification and management of patients by rescue services. […] The high PPV in patients with increased GFAP values opens the door to an earlier treatment of patients with severe intracranial hemorrhage. This includes rapid blood pressure lowering as well as the reversal of anticoagulation (e.g. by Andexanet alpha or Idarucizumab) in the prehospital phase.

• #55 Early diagnosis of traumatic intracranial hematomas

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6992895/

  The decision to operate on an intracerebral hematoma is based on the patients general condition, associated brain injuries, site and size of the hematoma, the intracranial pressure (ICP), and the magnitude of the mass effect. […] Delayed intracranial hematomas are a treatable cause of secondary injury if identified early, but can cause significant disability or death if not promptly recognized and treated. […] Serial CT scans are the most reliable method for detecting a delayed hematoma. […] Infrascanner is a clinically effective screening solution for head trauma patients in prehospital settings, where timely triage is critical.

• #56 Handheld Brain Hematoma Detector Provides Faster Diagnosis in Field – Medical Design Briefs

  https://www.medicaldesignbriefs.com/component/content/article/15927-handheld-brain-hematoma-detector-provides-faster-diagnosis-in-field

  An estimated one and half million individuals seek medical treatment for head trauma in the US each year, and annually about 10 million individuals seek treatment for head trauma worldwide. Intracranial hematomas resulting from a traumatic brain injury are a life-threatening, but treatable cause of secondary brain injury in patients who have sustained head trauma. But, successful treatment often relies upon timely diagnosis and intervention prior to the occurrence of brain damage. A computed tomography (CT) scan is the current clinical standard examination to detect this condition. […] Enter the Infrascanner, a handheld device that uses nearinfrared (NIR) technology to detect intracranial bleeding, identifying those patients who would most benefit from immediate referral to a CT scan and neurosurgical intervention.

• #57 Brain Injury Diagnosis Scanner: Brain Hematoma Detection | InfraScan

  https://infrascanner.com/about/

  Intracranial hematomas are an important and, if detected early, treatable cause of secondary brain injury in patients with head trauma. […] The basic method for intracranial hematomas detection with NIR spectroscopy is based on the differential light absorption associated with the injured versus the non-injured parts of brain. […] Detects hematomas greater than 3.5 cc in volume. […] For all bleeds within the detection capabilities of Infrascanner (bleeds of more than 3.5 mL), the sensitivity was 94% and the specificity 96%. In those patients who required surgical intervention, the device demonstrated 100% sensitivity.

• #58 Early diagnosis of traumatic intracranial hematomas

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6992895/

  Timing of the intervention for intracranial hematomas is critical for its success, specifically since expansion of the hemorrhage can result in debilitating and sometimes fatal outcomes. […] Infrascanner demonstrates high sensitivity (adults: 92.5% and children: 93%) and specificity (adults: 82.9% and children: 86.5%) in detecting intracranial hematomas 3.5mL in volume and 2.5cm from the surface of the brain. […] Diagnostic and treatment protocols mandate that a patient suffering from head trauma receive immediate medical assessment including a complete neurological examination. […] The gold standard imaging test is a computed tomography (CT) scan, which creates a series of cross-sectional x-ray images of the head and brain and can show bone fractures as well as the presence of hemorrhage, hematomas, contusions, brain tissue swelling, and tumors.

• #59 Brain Injury Diagnosis Scanner: Brain Hematoma Detection | InfraScan

  https://infrascanner.com/about/

  Intracranial hematomas are an important and, if detected early, treatable cause of secondary brain injury in patients with head trauma. […] The basic method for intracranial hematomas detection with NIR spectroscopy is based on the differential light absorption associated with the injured versus the non-injured parts of brain. […] Detects hematomas greater than 3.5 cc in volume. […] For all bleeds within the detection capabilities of Infrascanner (bleeds of more than 3.5 mL), the sensitivity was 94% and the specificity 96%. In those patients who required surgical intervention, the device demonstrated 100% sensitivity.

• #60 Intracerebral hemorrhage – Wikipedia

  https://en.wikipedia.org/wiki/Intracerebral_hemorrhage

  Both computed tomography angiography (CTA) and magnetic resonance angiography (MRA) have been proved to be effective in diagnosing intracranial vascular malformations after ICH. […] Diagnosis is typically by CT scan. […] Intraparenchymal hemorrhage can be recognized on CT scans because blood appears brighter than other tissue and is separated from the inner table of the skull by brain tissue. […] Apart from CT scans, haematoma progression of intracerebral haemorrhage can be monitored using transcranial ultrasound.

• #61 Advanced machine learning in action: identification of intracranial hemorrhage on computed tomography scans of the head with clinical workflow integration | npj Digital Medicine

  https://www.nature.com/articles/s41746-017-0015-z

  Intracranial hemorrhage (ICH) requires prompt diagnosis to optimize patient outcomes. […] Computed tomography (CT) of the head is the most widely used tool for diagnosing acute ICH, and the timing of diagnosis, therefore, depends on how quickly a head CT is both completed and subsequently interpreted by a clinician. […] Automatic triage of imaging studies using computer algorithms has the potential to detect ICH earlier, ultimately leading to improved clinical outcomes. […] The purpose of this study was twofold. The first goal was to develop a predictive deep learning model capable of detecting ICH based on a large clinical database of head CT studies. Second, we aimed to implement and test the predictive model in real time as a radiology workflow optimization tool. […] The clinical implementation phase utilized the algorithm to reprioritize radiology worklists.

• #62

  https://link.springer.com/article/10.1007/s00330-019-06163-2

  To evaluate the performance of a novel three-dimensional (3D) joint convolutional and recurrent neural network (CNN-RNN) for the detection of intracranial hemorrhage (ICH) and its five subtypes (cerebral parenchymal, intraventricular, subdural, epidural, and subarachnoid) in non-contrast head CT. […] The accurate diagnosis of bleeding becomes critical for clinicians to take clinical interventions. […] Therefore, an automated triage system for accurate ICH detection is desirable to reduce the rate of misdiagnosis. […] This study aimed at developing a novel framework for automated and accurate ICH detection. […] The proposed method was able to accurately detect ICH and its subtypes with fast speed, suggesting its potential for assisting radiologists and physicians in their clinical diagnosis workflow.

• #63

  https://link.springer.com/article/10.1007/s00330-019-06163-2

  The performance of the automated algorithm was superior to the average performance of three junior radiology trainees in this work, suggesting its potential to reduce initial misinterpretations. […] The results showed that its performance was superior to the average performance of the three junior radiology trainees for both the two-type and five-type tasks. […] In summary, our proposed algorithm could assist detection of ICH and subtypes with high accuracy and may potentially serve as a useful tool to assist diagnosis of ICH.

• #64 Advanced machine learning in action: identification of intracranial hemorrhage on computed tomography scans of the head with clinical workflow integration | npj Digital Medicine

  https://www.nature.com/articles/s41746-017-0015-z

  Intracranial hemorrhage (ICH) requires prompt diagnosis to optimize patient outcomes. […] Computed tomography (CT) of the head is the most widely used tool for diagnosing acute ICH, and the timing of diagnosis, therefore, depends on how quickly a head CT is both completed and subsequently interpreted by a clinician. […] Automatic triage of imaging studies using computer algorithms has the potential to detect ICH earlier, ultimately leading to improved clinical outcomes. […] The purpose of this study was twofold. The first goal was to develop a predictive deep learning model capable of detecting ICH based on a large clinical database of head CT studies. Second, we aimed to implement and test the predictive model in real time as a radiology workflow optimization tool. […] The clinical implementation phase utilized the algorithm to reprioritize radiology worklists.

• #65 Intracranial hematoma – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/intracranial-hematoma/symptoms-causes/syc-20356145

  An intracranial hematoma is a collection of blood within the skull. […] It usually requires immediate treatment. This might include surgery to remove the blood. […] An intracranial hematoma can be life-threatening and needs emergency treatment. […] All three types require medical attention as soon as symptoms appear. Prompt medical care may prevent permanent brain damage. […] An epidural hematoma that affects an artery in your brain can be deadly without prompt treatment. […] An intracerebral hematoma occurs when blood pools in the tissues of the brain. […] Activities that increase the risk of a bad head injury, such as riding a motorcycle or bicycle without a helmet, also raise the risk of an intracranial hematoma. […] The risk of a subdural hematoma increases with age. […] Some conditions also may increase the risk of having an intracerebral hematoma. […] To prevent or minimize a head injury that may cause an intracranial hematoma: Wear a helmet and make sure your kids wear helmets. […] All three types require medical attention as soon as symptoms appear.

• #66 Intracranial hematoma – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/intracranial-hematoma/symptoms-causes/syc-20356145

  An intracranial hematoma is a collection of blood within the skull. […] It usually requires immediate treatment. This might include surgery to remove the blood. […] An intracranial hematoma can be life-threatening and needs emergency treatment. […] All three types require medical attention as soon as symptoms appear. Prompt medical care may prevent permanent brain damage. […] An epidural hematoma that affects an artery in your brain can be deadly without prompt treatment. […] An intracerebral hematoma occurs when blood pools in the tissues of the brain. […] Activities that increase the risk of a bad head injury, such as riding a motorcycle or bicycle without a helmet, also raise the risk of an intracranial hematoma. […] The risk of a subdural hematoma increases with age. […] Some conditions also may increase the risk of having an intracerebral hematoma. […] To prevent or minimize a head injury that may cause an intracranial hematoma: Wear a helmet and make sure your kids wear helmets. […] All three types require medical attention as soon as symptoms appear.

• #67 Intracranial hematoma – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/intracranial-hematoma/symptoms-causes/syc-20356145

  An intracranial hematoma is a collection of blood within the skull. […] It usually requires immediate treatment. This might include surgery to remove the blood. […] An intracranial hematoma can be life-threatening and needs emergency treatment. […] All three types require medical attention as soon as symptoms appear. Prompt medical care may prevent permanent brain damage. […] An epidural hematoma that affects an artery in your brain can be deadly without prompt treatment. […] An intracerebral hematoma occurs when blood pools in the tissues of the brain. […] Activities that increase the risk of a bad head injury, such as riding a motorcycle or bicycle without a helmet, also raise the risk of an intracranial hematoma. […] The risk of a subdural hematoma increases with age. […] Some conditions also may increase the risk of having an intracerebral hematoma. […] To prevent or minimize a head injury that may cause an intracranial hematoma: Wear a helmet and make sure your kids wear helmets. […] All three types require medical attention as soon as symptoms appear.

• #68 Early diagnosis of traumatic intracranial hematomas

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6992895/

  The decision to operate on an intracerebral hematoma is based on the patients general condition, associated brain injuries, site and size of the hematoma, the intracranial pressure (ICP), and the magnitude of the mass effect. […] Delayed intracranial hematomas are a treatable cause of secondary injury if identified early, but can cause significant disability or death if not promptly recognized and treated. […] Serial CT scans are the most reliable method for detecting a delayed hematoma. […] Infrascanner is a clinically effective screening solution for head trauma patients in prehospital settings, where timely triage is critical.

• #69 Brain Bleed (Intracranial Hemorrhage): Causes & Symptoms

  https://my.clevelandclinic.org/health/diseases/14480-brain-bleed-hemorrhage-intracranial-hemorrhage

  Prompt medical treatment can limit damage to your brain, which will improve your chance of recovery. […] You may need rehabilitation after a brain bleed. Depending on the severity of the bleed, brain damage is a possibility that can affect your ability to complete your daily routine. Rehabilitation can help you regain the functions needed for daily living and prevent future brain bleeds. […] If you suspect a brain bleed, the sooner you get to the emergency room, the better your chance of survival. Don’t hesitate if you suspect something’s wrong. Let a healthcare professional determine if you have a brain emergency.

• #70 Acute intracerebral haemorrhage: diagnosis and management | Practical Neurology

  https://pn.bmj.com/content/21/2/128

  Early diagnosis of macrovascular causes of ICH allows timely starting of specific treatment and refines the prognosis. […] The presence of expanding haematoma and vasogenic oedema inside the fixed volume of the cranial vault can lead to a precipitous increase in intracranial pressure (ICP) and fatal brain herniation syndromes. […] The rapid delivery of a care bundle incorporating anticoagulation reversal, intensive blood pressure management and neurosurgery/critical care if required has been associated with a substantial improvement in 30-day case-fatality rates. […] The overarching goals of acute management are to stabilise the patient to ensure they survive the initial insult, and to prevent secondary brain injury. […] Management of the complications of ICH is a key focus of acute care.

• #71 Acute intracerebral haemorrhage: diagnosis and management | Practical Neurology

  https://pn.bmj.com/content/21/2/128

  Early diagnosis of macrovascular causes of ICH allows timely starting of specific treatment and refines the prognosis. […] The presence of expanding haematoma and vasogenic oedema inside the fixed volume of the cranial vault can lead to a precipitous increase in intracranial pressure (ICP) and fatal brain herniation syndromes. […] The rapid delivery of a care bundle incorporating anticoagulation reversal, intensive blood pressure management and neurosurgery/critical care if required has been associated with a substantial improvement in 30-day case-fatality rates. […] The overarching goals of acute management are to stabilise the patient to ensure they survive the initial insult, and to prevent secondary brain injury. […] Management of the complications of ICH is a key focus of acute care.

• #72 Intracerebral Hemorrhage: Diagnosis, Emergency Management, and Prognosis – emDocs

  https://www.emdocs.net/intracerebral-hemorrhage-diagnosis-emergency-management-and-prognosis/

  Once ICH is diagnosed, the vasculature can be evaluated by CT angiography or digital subtraction angiography. While not routinely necessary in the ED, these imaging studies may be of diagnostic utility to neurologists and neurosurgeons on a case-by-case basis. […] The ICH score can grade severity and predict 30-day mortality. The score is easy to use and based on: GCS, age, ICH volume, IVH and hemorrhage origin. […] Hematoma volume can be calculated from CT imaging using the ABC/2 technique. […] Hematoma expansion from baseline is of particular concern because it is associated with early clinical deterioration. […] The „spot sign” occurs with contrast extravasation into hematoma resulting in a bright spot within the hematoma on CTA. The spot sign may represent active bleeding and is a predictor of hematoma expansion and poor outcome.

• #73 Intracerebral hemorrhage (ICH) – EMCrit Project

  https://emcrit.org/ibcc/ich/

  Hematoma expansion will often occur within 6-24 hours (or later in anticoagulated patients). […] The spot sign reveals leakage of contrast into the hematoma (predicting expansion with 51% sensitivity and 85% specificity). […] Cerebral vein thrombosis with hemorrhagic transformation is an important cause of ICH, because this requires specific management. […] CT scan with CT angiography is often the initial investigation. […] In patients with spontaneous intraventricular hemorrhage and no detectable parenchymal hemorrhage, catheter intra-arterial digital subtraction angiography is recommended to exclude a vascular cause.

• #74 Intracerebral Hemorrhage: Diagnosis, Emergency Management, and Prognosis – emDocs

  https://www.emdocs.net/intracerebral-hemorrhage-diagnosis-emergency-management-and-prognosis/

  Once ICH is diagnosed, the vasculature can be evaluated by CT angiography or digital subtraction angiography. While not routinely necessary in the ED, these imaging studies may be of diagnostic utility to neurologists and neurosurgeons on a case-by-case basis. […] The ICH score can grade severity and predict 30-day mortality. The score is easy to use and based on: GCS, age, ICH volume, IVH and hemorrhage origin. […] Hematoma volume can be calculated from CT imaging using the ABC/2 technique. […] Hematoma expansion from baseline is of particular concern because it is associated with early clinical deterioration. […] The „spot sign” occurs with contrast extravasation into hematoma resulting in a bright spot within the hematoma on CTA. The spot sign may represent active bleeding and is a predictor of hematoma expansion and poor outcome.

• #75 Intracerebral Hemorrhage – Neurologic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/neurologic-disorders/stroke/intracerebral-hemorrhage

  Diagnosis of intracerebral hemorrhage is suggested by sudden onset of headache, focal neurologic deficits, and impaired consciousness, particularly in patients with risk factors. […] Immediate CT or MRI is necessary. Neuroimaging is usually diagnostic. If neuroimaging shows no hemorrhage but subarachnoid hemorrhage is suspected clinically, lumbar puncture is necessary to look for xanthochromia. […] CT angiography, done within hours of bleeding onset, may show areas where contrast extravasates into the clot (spot sign); this finding indicates that bleeding is continuing and suggests that the hematoma will expand and the outcome will be poor.

• #76 Acute intracerebral haemorrhage: diagnosis and management | Practical Neurology

  https://pn.bmj.com/content/21/2/128

  Early diagnosis of macrovascular causes of ICH allows timely starting of specific treatment and refines the prognosis. […] The presence of expanding haematoma and vasogenic oedema inside the fixed volume of the cranial vault can lead to a precipitous increase in intracranial pressure (ICP) and fatal brain herniation syndromes. […] The rapid delivery of a care bundle incorporating anticoagulation reversal, intensive blood pressure management and neurosurgery/critical care if required has been associated with a substantial improvement in 30-day case-fatality rates. […] The overarching goals of acute management are to stabilise the patient to ensure they survive the initial insult, and to prevent secondary brain injury. […] Management of the complications of ICH is a key focus of acute care.

• #77 Intracranial Hemorrhage – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470242/

  Implement evidence-based protocols and proper evaluation, imaging, and monitoring protocols for timely diagnosis and management of intracranial hemorrhage. […] A non-contrast computed tomography (CT) scan of the head is the imaging modality unless additional modalities are indicated for further evaluation. […] If intracranial pressure (ICP) increases, a Cushing response (hypertension, bradycardia, and bradypnea) may occur as compensation. […] The characteristic imaging finding is a hyperdense extra-axial lens-shaped (biconvex) opacity. […] Acute subarachnoid hemorrhage is typically hyperdense on CT imaging. […] If the CT scan is negative and a strong suspicion of subarachnoid hemorrhage exists, a lumbar puncture (LP) should be considered. […] Identifying the cause of non-traumatic subarachnoid hemorrhage helps guide further treatment.

• #78

  https://www.ijcmph.com/index.php/ijcmph/article/view/3625

  Subdural hematoma is diagnosed using CT or MRI imaging. […] Acute subdural hematoma is an emergency and requires prompt diagnosis using CT most of the time, and management requires surgery as well as reversal of anticoagulants. […] Subdural hematoma are clinical emergencies that require immediate and rapid management to prevent significant morbidity and mortality. […] Controlling intracranial pressure is an important factor for predicting the outcomes of subdural hematoma, and should thus be continuously monitored and corrected.

• #79 Intracranial Hemorrhage – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470242/

  Immediate neurosurgical consultation is strongly advised for all cases of hemorrhage, especially when alarming signs such as airway compromise, respiratory failure, or hemodynamic instability are evident. […] Proper evaluation, imaging, and monitoring for signs of impending deterioration should guide the implementation of best practice management. Early neurosurgical consultation is essential, as management strategies vary depending on the type of hemorrhage. […] This activity offers a comprehensive overview of intracranial hemorrhage types and the crucial role of the interprofessional healthcare team in treating patients experiencing various types of intracranial hemorrhages. […] This activity also enables clinicians to gain insights into integrating specialist consultation with evidence-based clinical judgment to mitigate the risk of morbidity and mortality associated with intracranial hemorrhages.

• #80 Intracranial Hemorrhage – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470242/

  Immediate neurosurgical consultation is strongly advised for all cases of hemorrhage, especially when alarming signs such as airway compromise, respiratory failure, or hemodynamic instability are evident. […] Proper evaluation, imaging, and monitoring for signs of impending deterioration should guide the implementation of best practice management. Early neurosurgical consultation is essential, as management strategies vary depending on the type of hemorrhage. […] This activity offers a comprehensive overview of intracranial hemorrhage types and the crucial role of the interprofessional healthcare team in treating patients experiencing various types of intracranial hemorrhages. […] This activity also enables clinicians to gain insights into integrating specialist consultation with evidence-based clinical judgment to mitigate the risk of morbidity and mortality associated with intracranial hemorrhages.

• #81 Intracranial Hemorrhage – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470242/

  Immediate neurosurgical consultation is strongly advised for all cases of hemorrhage, especially when alarming signs such as airway compromise, respiratory failure, or hemodynamic instability are evident. […] Proper evaluation, imaging, and monitoring for signs of impending deterioration should guide the implementation of best practice management. Early neurosurgical consultation is essential, as management strategies vary depending on the type of hemorrhage. […] This activity offers a comprehensive overview of intracranial hemorrhage types and the crucial role of the interprofessional healthcare team in treating patients experiencing various types of intracranial hemorrhages. […] This activity also enables clinicians to gain insights into integrating specialist consultation with evidence-based clinical judgment to mitigate the risk of morbidity and mortality associated with intracranial hemorrhages.

• #82 Intracerebral Hemorrhage: Diagnosis, Emergency Management, and Prognosis – emDocs

  https://www.emdocs.net/intracerebral-hemorrhage-diagnosis-emergency-management-and-prognosis/

  Intraventricular hemorrhage (IVH) results from hematoma expansion into ventricles and occurs in half of all cases of ICH. […] Neurosurgery should be emergently consulted in cases of ICH as a subset of patients will benefit from surgical intervention. An external ventricular drain (EVD) should be considered when IVC leads to hydrocephalus, reduced consciousness or evidence of transtentorial herniation. […] Hematoma evacuation is recommended in the management of cerebellar hematomas with evidence of hydrocephalus or brainstem compression. Surgical hematoma evacuation may also be considered in deteriorating patients with supratentorial hematomas as a life-saving measure. […] Early and aggressive optimization of care can impact outcomes in ICH despite its intimidating prognosis. Initially, key steps include: a primary and secondary survey, identifying patients with potential ICH, and rapidly performing a NCCT brain.

• #83 Intracranial Hemorrhage Diagnosis & Treatment Market Analysis

  https://media.market.us/intracranial-hemorrhage-diagnosis-treatment-market-news/

  Global Intracranial Hemorrhage Diagnosis Treatment Market size is expected to be worth around USD 3.0 Billion by 2033 from USD 1.6 Billion in 2023, growing at a CAGR of 6.6% during the forecast period from 2024 to 2033. […] Intracranial hemorrhage (ICH) is a life-threatening condition characterized by bleeding within the skull, which can result from trauma, high blood pressure, aneurysm rupture, or underlying medical conditions. […] Rapid diagnosis through CT scans or MRI is critical for determining the severity and appropriate treatment. […] The diagnosis segment plays a crucial role, accounting for 43% of the total market share. […] Computed Tomography (CT) remains the primary diagnostic tool, offering rapid imaging and precise detection of intracranial hemorrhages, especially in emergency cases.

• #84 Intracranial Hemorrhage Diagnosis & Treatment Market Analysis

  https://media.market.us/intracranial-hemorrhage-diagnosis-treatment-market-news/

  Magnetic Resonance Imaging (MRI) provides superior soft tissue contrast and helps differentiate between acute and chronic hemorrhages, aiding in effective treatment decisions. […] Effective blood pressure management has been shown to reduce the incidence of ICH, highlighting the importance of hypertension control in preventive healthcare strategies.

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