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Intracerebral or Intraparenchymal Hemorrhage (IPH) denotes bleeding into the brain tissue.


The most common causes of IPH in older adults are brain small vessel diseases (SVD) such as hypertensive SVD and cerebral amyloid angiopathy (CAA). Hypertensive bleeds are mostly deep-seated in the brain whereas CAA related IPH are more superficial.


Gross blood vessel pathologies (aneurysms, arteriovenous malformations) and mass lesions (tumors, metastases) although less common should always be considered and ruled out using appropriate testing. The causes of IPH and the necessary workup to diagnose such cause are summarized below.  Understanding the underlying pathology is very important as some causes need to be immediately treated and different causes are associated with different risk of recurrence. 

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