Table 1.
Major causes of intracerebral hemorrhage
| Etiology | Proposed mechanism underlying hemorrhage |
|---|---|
| Hypertension |
Vascular remodeling, formation microaneurysms. |
| Amyloid angiopathy |
β-amyloid induced vascular damage. |
| Ateriovenous malformations |
Weakened vascular wall. |
| Cerebral cavernous malformations |
Weakened vascular wall. |
| Anti-coagulant usage |
Loss of coagulation in response to bleeding (microbleeds). |
| Ischemic stroke* |
Ischemia/reperfusion induced vascular injury |
| Traumatic brain injury* |
Physical disruption of vessels |
| Tumors* | Abnormal vasculature |
*In addition to primary spontaneous ICH, a hemorrhage can also be secondary to other adverse events including an ischemic stroke (hemorrhagic transformation), brain tumors and traumatic brain injury. Such hemorrhages can have an important role in brain injury following such events. In ischemic stroke, the risk of a symptomatic ICH is enhanced by inducing reperfusion with tissue plasminogen activator (tPA).