Intracerebral (intraparenchymal) hemorrhage

• HTN vascular disease accounts for > ½ of intraparenchymal hemorrhages

• Usually affects deep gray matter (like basal ganglia and thalamus)

• Charcot-Brouchard microaneurysms: “leaky” microscopic outpouchings of vessels due to HTN

• Lacunar infarcts

  • Cystic spaces in deep gray matter

  • The hypertensive blood vessel creates a space that gets left behind

• Hypertensive encephalopathy

  • Associated with very high BP

  • See H/A, seizures, and confusion

• Multi-infarct dementia

  • Multiple infarcts over time wipe out enough gray matter to wipe out cognitive abilities

  • Presents as a progressive dementia

• Binswanger’s disease: dementia and white matter loss from multiple infarcts

Category: Pathology Notes