This work was done by 2nd year student in faculty of medicine,Menoufia University,Egypt and under supervision of staff of anatomy and embryology department

2.  Name: Amira Esam
 Name: Reem Mohamed
 Name: Hadeer Khalfalla
 Name: Yossra Helal
 Name: Rawda Abdelmenam
 Name: Tasneem Tarek
 Name: Yara Sabry
 Name: Reham Abd Elhameed
 Name: Alaa Maged
 Name : Alaa Mohamed
 Name: Walaa Shaban
Designed by
Under supervision
of
2nd year: group(26) -2017- Anatomy department

3. 1) Anatomy of Cerebral Vessels
2) Cerebral Hemorrhage
3) Causes
4) Epidemiology
5) Stages
6) Clinical Picture
7) Investigation
8) Treatment
9) Follow UP
10)Patient Education
2nd year: group(26) -2017- Anatomy department

4. IS AN ANASTOMOTIC SYSTEM OF ARTERIES THAT
SITS AT THE BASE OF THE BRAIN.
• ANTERIOR CEREBRAL ARTERY
• ICA
• POSTERIOR COMMUNTICATING ARTERY
• POSTIRIOR CEREBRAL ARTERY
2nd year: group(26) -2017- Anatomy department

5. SUPERFICIAL SYSTEM OF VEINS :-
SUPERIOR CEREBRAL VEIN
MIDDLE CEREBRAL VEIN ( SUPERFICIAL &
DEEP )
INFERIOR CEREBRAL VEIN
DEEP SYSTEM OF VEINS :-
THALAMOSTRIATE VEINS
CHOROID VEINS
INTERNAL CEREBRAL VEINS
GREAT CEREBRAL VEIN
Cerebral
Veins
2nd year: group(26) -2017- Anatomy department

6. 2nd year: group(26) -2017- Anatomy department

7.  IS THE PATHOLOGICAL ACCUMULATION OF BLOOD WITHIN THE CRANIAL VAULT MAY
OCCUR WITHIN BRAIN PARENCHYMA OR THE SURROUNDING MENINGEAL SPACES.
 IT ACCOUNTS FOR 8-13% OF ALL STROKES .
 ALSO IS MORE LIKELY TO RESULT IN DEATH OR MAJOR DISABILITY
 INTRACEREBRAL HEMORRHAGE AND ACCOMPANYING EDEMA MAY DISRUPT OR
COMPRESS ADJACENT BRAIN TISSUE, LEADING TO NEUROLOGICAL DYSFUNCTION.
 DISPLACEMENT OF BRAIN PARENCHYMA MAY CAUSE ↑(ICP) AND FATAL HERNIATION
SYNDROMES.
2nd year: group(26) -2017- Anatomy department

8. CAUSES
Hypertensio
n
Aneurysm A-V
malformation
Tumor Cranial
Trauma
Anti Coagulant
Drugs

9. • Age of 55 and
doubles with
each deacade
till 80
Age
• Africans due to
hypertension
Race
• Slight male
predominance
Sex
Epidemiology
2nd year: group(26) -2017- Anatomy department

10. Phase TIME HB ,
Location
o Hyper acute < 24 h Oxyhemoglobin,
intracellular
oAcute 1-3 d Deoxyhemoglobin,
intracellular
o Early subacute >3 d Methemoglobin,
intracellular
o Late subacute >7 d Methemoglobin,
extracellular
o Chronic >14 d Ferritin and hemosiderin,
extracellular
Stages
2nd year: group(26) -2017- Anatomy department

12. Altered
conscio
us level
(50%)
Headach
e
( 40%)
Nausea
and
vomiting
( 40%)
Seizures
( 6-7%)
focal
numbness,
tingling, or
weakness
Onset of symptoms of intracerebral hemorrhage is usually during daytime
activity, with progressive (ie, minutes to hours) development of the following:

13. NEUROLOGICAL SYMPTOMS ACCORDING
TO SITE:
Thalamus
sensory loss
Brain stem
facial weakness
Cerebellum
Ataxia

14. • ECG DIAGNOSIS: DEEP T WAVE INVERSIONS ASSOCIATED WITH
INTRACRANIAL HEMORRHAGE
• SPONTANEOUS CEREBRAL HEMORRHAGE IN A PATIENT WITH ESSENTIAL
HYPERTENSION.
• BOTH CT ANGIOGRAPHY & MR ANGIOGRAPHY HAVE PROVIDE TO BE EFFECTIVE IN THE
DIAGNOSIS OF INTRACRANIAL HEMORRHAGE SO CT IS PERFORMED TO EXCLUDE A 2RY
CAUSE OF HEMORRHAGE OR TO DETECT A SPOT SIGN.
2ND YEAR: GROUP(26) -2017- ANATOMY DEPARTMENT

15. INTRAPARENCHYMAL HEMORRHAGE CAN BE
RECOGNIZED ON CT SCANS AS THE BLOOD APPEARS
BRIGHTER THAN OTHER TISSUES ALSO THE TISSUE THAT
SURROUND THE BLEED KINDA DENSE THAN THE REST OF
THE BRAIN BECAUSE OF EDEMA
• MAGNETIC RESONANCE IMAGING
(MRI)
• LUMBAR PUNCTURE (CSF
EXAMINATION)
• GRADIENT ECHO (GRE)
2ND YEAR: GROUP(26) -2017- ANATOMY

16. SUBACUTE SUBDURAL HEMATOMA IN A RIGHT FRONTOPARIETAL CONCAVITY.
CT SCAN (CT) SHOWS AN ISOATTENUATING-TO-HYPOATTENUATING
SUBDURAL HEMATOMA. BOTH T1-WEIGHTED (T1W) AND T2-WEIGHTED (T2W)
MR IMAGES SHOW HIGH SIGNAL INTENSITY SUGGESTIVE OF A LATE
SUBACUTE HEMORRHAGE.
2nd year: group(26) -2017- Anatomy department

17. THIS MRI REVEALS HEMORRHAGIC
TRANSFORMATION OF AN ISCHEMIC
INFARCT.
2nd year: group(26) -2017- Anatomy department

18. complications
Seizures
Hydrocephalus Brain
Herniation
Pulmonary
Embolism
Venous
Thrombosis

19.  PHARMACOLOGICAL :-
• ANTIHYPERTENSIVE AGENTS
• OSMOTIC DIURETICS
• ANTIPYRETICS, ANALGESICS
• ANTICONVULSANTS
 NON PHARMACOLOGICAL:-
• SURGICAL CARE
• DIET
• ACTIVITY
Treatment
2nd year: group(26) -2017- Anatomy department

20. Follow Up
Further outpatient Care
Continued physical
,occupational and speech
therapy maybe required
Further inpatient Care
Initial management of intra cerebral
hemorrhage generally is conducted
in the ICU
2nd year: group(26) -2017- Anatomy department

21.  EDUCATE PATIENTS REGARDING THE FOLLOWING:-
o TREATMENT OF HYPERTENSION
o WARNING SIGNS AND SYMPTOMS OF STROKE AS WELL AS
PREVENTING MEASURING
o TRAUMATIC BRAIN INJURY
o ADVERSE EFFECTS OF ALCOHOL AND SYMPATHOMIMETIC
SUBSTANCES
Patient Education
2nd year: group(26) -2017- Anatomy department

22. THANK YOU