Physical Symptoms
Clinical manifestations of intraparenchymal hemorrhage are determined by the size and location of hemorrhage, but may include the following:
- Hypertension, fever, or cardiac arrhythmias
- Nuchal rigidity
- Subhyaloid retinal hemorrhages
- Altered level of consciousness
- Anisocoria, Nystagmus
- Focal neurological deficits
- Putamen - Contralateral hemiparesis, contralateral sensory loss, contralateral conjugate gaze paresis, homonymous hemianopsia, aphasia, neglect, or apraxia
- Thalamus - Contralateral sensory loss, contralateral hemiparesis, gaze paresis, homonymous hemianopia, miosis, aphasia, or confusion
- Lobar - Contralateral hemiparesis or sensory loss, contralateral conjugate gaze paresis, homonymous hemianopia, abulia, aphasia, neglect, or apraxia
- Caudate nucleus - Contralateral hemiparesis, contralateral conjugate gaze paresis, or confusion
- Brain stem - Quadriparesis, facial weakness, decreased level of consciousness, gaze paresis, ocular bobbing, miosis, or autonomic instability
- Cerebellum - Ataxia, usually beginning in the trunk, ipsilateral facial weakness, ipsilateral sensory loss, gaze paresis, skew deviation, miosis, or decreased level of consciousness
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