Diagnosis of intracerebral hemorrhage

Condition analysis:
Both computed tomography angiography (CTA) and magnetic resonance angiography (MRA) have been proved to be effective in diagnosing intracranial vascular malformations after ICH. So frequently, a CT angiogram will be performed in order to exclude a secondary cause of hemorrhage or to detect a "spot sign".

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. The tissue surrounding a bleed is often less dense than the rest of the brain because of edema, and therefore shows up darker on the CT scan.

Instructions:
Stereotactic aspiration is a less invasive technique preferred for large hematomas located deep inside the brain. The procedure requires attaching a stereotactic frame to your head with four pins (screws). The pin site areas are injected with local anesthesia to minimize discomfort. A metal cage, which looks like a birdcage, is placed on the frame. Next, you undergo a CT scan to help the surgeon pinpoint the exact coordinates of the hematoma. In the OR, the surgeon drills a small hole about the size of quarter in the skull. With the aid of the stereotactic frame, a hollow needle is passed through the hole, through the brain tissue, directly into the clot. The hollow needle is attached to a large syringe, which the surgeon uses to suction out the contents of the blood clot.