Traumatic causes of ICH include depressed skull fractures, penetrating missile injuries (gunshot wounds or stab wounds), or a sudden acceleration-deceleration motion. Depressed skull fractures cause penetration of bone into cerebral tissue. A high-velocity penetration (bullet) can produce shock waves that are transmitted throughout the brain, in addition to the injury caused by

528 Intracerebral Hematoma the bullet directly. A low-velocity penetrating injury (knife) may involve only focal damage and no loss of consciousness. Motor vehicle crashes (MVCs) cause rapid acceleration-deceleration injuries. In cases in which there is no apparent cause for spontaneous ICH, hypertension is the most frequently associated disease. Other potential causes of ICH include hemorrhage at the site of a brain tumor and cerebrovascular accidents.

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