Symptoms:

Symptoms depend on the location of the bleeding in the brain and how much damage has occurred. Symptoms most commonly develop suddenly, without warning, and often during activity. There is a rapid loss of function on one side of the body.

The symptoms can be the same as those that result from a stroke, and may include:

• Decreased consciousness
  • Comatose
  • Lethargic
  • Sleepy
  • Stuporous
  • Unconscious
  • Withdrawn
• Difficulty reading or writing
• Difficulty speaking or understanding others
• Difficulty swallowing
• Headache
  • Gets worse when you change position, such as bending, straining, or coughing
  • May wake you up from sleep
  • Occurs when lying flat
• Loss of coordination
• Loss of balance
• Movement changes
  • Difficulty moving any body part
  • Loss of fine motor skills
• Nausea or vomiting
• Seizure
• Sensation changes
  • Decreased sensation
  • Numbness
  • Tingling
• Weakness of any body part
• Vision changes
  • Any change in vision
  • Decreased vision
  • Loss of vision off to one side

Signs and tests:

A neurological exam may show signs of increased pressure in the brain, such as swelling of the optic nerve or changes in eye movement. The doctor will check your reflexes and movement to see if there have been any changes in brain function.

Changes in function may help reveal the location of the problem within the brain.

In order to be classified as a hypertensive hemorrhage, the person must have some history of high blood pressure. Often the blood pressure is still very high when the patient is examined. Other tests may show other signs of high blood pressure, such as abnormal blood vessels in the eyes or problems with kidney function.

Tests to determine the amount and cause of bleeding include:

• CBC
• Platelet count
• Bleeding time
• Prothrombin time
• Partial thromboplastin time
• Liver function tests
• Kidney function tests
• Angiography of the head (if symptoms allow enough time to perform this test) -- reveals any aneurysm or arteriovenous malformation present

However, an image of the brain is needed to prove the condition is due to intracerebral hemorrhage. This can be done with a:

• Head CT scan (preferred if the hemorrhage began less than 48 hours earlier)
• Head MRI