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Editorial review
EmergencyCerebrovascular

Intracranial Hemorrhage

Editorially reviewedEditorial review Updated 1 min read2 references
Contents

In brief: Intracranial hemorrhage is a medical emergency involving bleeding inside the skull, including within brain tissue, the ventricles, or other intracranial spaces.

Presentation may include severe headache, vomiting, weakness, seizure, or reduced consciousness. CT is commonly used for rapid detection, followed by vascular imaging and other studies as appropriate.

In moyamoya disease, intracranial hemorrhage may arise from fragile collateral vessels or associated aneurysms.

The Japan Adult Moyamoya trial informed guidance about revascularization for selected hemorrhagic presentations, particularly where posterior collateral patterns suggest higher rebleeding risk. [1] Decisions remain individualized because hemorrhage location, aneurysms, hemodynamics, age, and operative risk matter. [2]

Hemorrhagic and ischemic risk can coexist in the same patient. Reducing one risk should not be discussed without considering the other.