Vascular disruption and blood–brain barrier dysfunction in intracerebral hemorrhage

Table 1 Major causes of intracerebral hemorrhage

Etiology	Proposed mechanism underlying hemorrhage
Hypertension	Vascular remodeling, formation microaneurysms.
Amyloid angiopathy	β-amyloid induced vascular damage.
Ateriovenous malformations	Weakened vascular wall.
Cerebral cavernous malformations	Weakened vascular wall.
Anti-coagulant usage	Loss of coagulation in response to bleeding (microbleeds).
Ischemic stroke*	Ischemia/reperfusion induced vascular injury
Traumatic brain injury*	Physical disruption of vessels
Tumors*	Abnormal vasculature

*In addition to primary spontaneous ICH, a hemorrhage can also be secondary to other adverse events including an ischemic stroke (hemorrhagic transformation), brain tumors and traumatic brain injury. Such hemorrhages can have an important role in brain injury following such events. In ischemic stroke, the risk of a symptomatic ICH is enhanced by inducing reperfusion with tissue plasminogen activator (tPA).

ISSN: 2045-8118