What is the main concern with intracranial hemorrhage?

Increased intracranial pressure (ICP) is a critical concern in cases of intracranial hemorrhage because it can lead to significant brain injury or even death. When bleeding occurs within the cranium, whether in the brain tissue itself or in the spaces surrounding it, the volume within the skull increases. This results in pressure on brain structures, which can compromise blood flow and lead to further ischemia and damage.

As ICP rises, it can cause a range of neurological symptoms, including altered mental status, focal neurologic deficits, seizures, and possibly herniation of brain tissue, where parts of the brain are forced from their normal location due to increased pressure. This pathway leads to worsening outcomes and heightened risk of morbidity.

While dehydration, electrolyte imbalances, spinal fluid leakage, severe headache, and nausea can accompany different medical conditions or injuries, they do not directly relate to the primary and most critical issue arising from an intracranial hemorrhage. Addressing increased ICP is essential in managing patients with intracranial bleeding to prevent irreversible damage and to stabilize their condition.