An increase in volume of >33% is detectable on repeated computed tomography (CT) in 38% of patients initially scanned within 3 hr after onset, and increase is evident within 1 hr in two-thirds of cases (9). This early hematoma growth occurs in the absence of coagulopathy and appears to result from continued bleeding or rebleeding at multiple sites within the first few hours after onset.
Therefore, the progress of an ICH is a dynamic process, and the consequent-associated neuronal injury is related to both the primary and the secondary injury. The primary injury is related to the direct tissue damage from the expanding hematoma, and causes for secondary injury include inflammation, edema formation, and intraventricular extension of the hemorrhage and accompanying hydrocephalus (Table 2).
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