Former Manchester United boss Sir Alex Ferguson has been hospitalized after suffering an Intracerebral hemorrhage or ICH. Strokes come in two varieties, hemorrhagic or ischemic. One is when a blood vessel bursts, and the other is when a blood vessel is blocked by a clot or embolus.
Damage occurs with ICH from two mechanisms. Mechanism 1 is when the blood vessel bursts, there’s an area of the brain not getting blood from the burst vessel. Mechanism 2 is the extruded blood forms a hematoma which causes mass effect on the surrounding brain.
Surgery is usually a craniotomy to remove the hematoma. A portion of the skull is removed, the dura is opened, and a small incision is made in the cortex. The hematoma is evacuated with suction. Note this only helps mechanism 2, there’s nothing to do about mechanism 1.
Prognosis depends on location (which area of the brain, which side of the brain) and size of the hematoma and damage to surrounding brain.
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