Intraparenchymale

Intraparenchymale is an adjective describing something located within the parenchyma, the functional tissue of an organ, as opposed to surrounding stroma or cavities. In medical usage it often refers to processes or lesions that occur inside the tissue of an organ, most commonly the brain.

In the brain, intraparenchymale hemorrhage refers to bleeding directly into brain parenchyma, also called intracerebral hemorrhage (ICH). It is a major form of stroke and is distinguished from bleeds that occur in the ventricles or subarachnoid space. Spontaneous ICH is most commonly due to hypertensive small vessel disease or cerebral amyloid angiopathy, but can also result from trauma, vascular malformations, brain tumors, hemorrhagic transformation of ischemic stroke, or coagulopathy.

The rupture of small penetrating arteries creates a hematoma within brain tissue, causing local edema, compression of adjacent structures, and raised intracranial pressure. Symptoms vary by location and size, typically including sudden headache, focal neurological deficits such as weakness or speech disturbance, and sometimes reduced consciousness.

Diagnosis usually begins with non-contrast CT to detect the hematoma; MRI can provide further characterization and help identify underlying etiologies. Additional imaging (CT angiography or MR angiography) and laboratory tests assess vascular disease, anticoagulation status, and other causes.

Management emphasizes stabilization and prevention of further bleeding, including careful blood pressure control, reversal of anticoagulation when indicated, and measures to control intracranial pressure. Neurosurgical evaluation is considered for hematoma evacuation when appropriate. Prognosis depends on hematoma size and location, age, and comorbidities; mortality remains substantial.