Which of the following is a common cause of intracerebral hemorrhage?

• A. Hypertension
• B. Aneurysm rupture
• C. Arteriovenous malformation
• D. Subarachnoid hemorrhage

Answer: (A)

Hypertension is the most common cause of intracerebral hemorrhage. Chronic high blood pressure damages the small penetrating arteries in deep brain structures through hyaline arteriolosclerosis and lipohyalinosis, weakening vessel walls and making them prone to rupture. When these small vessels rupture, blood spills into the brain tissue, producing an intraparenchymal bleed often in areas like the putamen, thalamus, pons, or cerebellum. This contrasts with aneurysm rupture, which more commonly leads to bleeding into the subarachnoid space (subarachnoid hemorrhage), and arteriovenous malformations can cause intraparenchymal hemorrhage but are less common than hypertensive bleeds. Subarachnoid hemorrhage refers to bleeding into the spaces around the brain, not into the brain tissue itself.