August 2014

Hemorrhagic Stroke

Hemorrhagic Stroke

Approximately 22% of all strokes are caused by cerebral hemorrhage. Causes of a sudden onset of intracranial hemorrhage or bleeding, commonly called apoplexy, are hypertension (10% to 15% of all cases), aneurysm (5% to 7%), bleeding into a tumor (3% to 5%), and a generalized bleeding tendency (1% to 2%).

Initially the effects of a hemorrhagic stroke are more damaging than that of an ischemic stroke. The hemorrhage may be over a larger area or involve a larger number of blood vessels. However, once the stroke is complete the long-term problems and care are virtually the same for both.

Hypertensive hemorrhages occur most commonly in the brain stem or in the lateral portion of the cerebral hemisphere near the pathways of the motor nerves of the body. When the hemorrhage extends into the motor tract, paralysis can occur. Partial or complete recovery of function can return over a long period of time, and treatment is aimed at reducing blood pressure and using physiotherapy to regain the use of the limbs. A significant hemorrhage, however, can result in coma, brain damage, and even death.

Aneurysms-- enlargements of small portions of blood vessels-- can rupture and bleed causing loss of circulation to the brain. When an aneurysm ruptures, it can create massive bleeding and release chemicals that produce spasm in the vessels surrounding it. An aneurysm is usually treated surgically.

Tumors must have an adequate blood supply to maintain their growth, and therefore some tumors secrete chemicals that promote blood-vessel growth. Certain tumors may produce too much of this factor, causing the vessels to enlarge excessively. This enlargement can result in an internal hemorrhage and sudden stroke. The stroke, unfortunately, may mask the existence of a tumor and delay a complete diagnosis.

Chemotherapy of tumors can also interfere with the production of platelets necessary for the formation of clots, if bleeding should occur in or around a vessel this can increase the possibility for a stroke to occur.

 

Symptoms

The symptoms are the same as those listed on the Stroke Home Page.

One factor that should always be considered is that severe headaches when followed by the other signs and symptoms described more common suggest the occurrence of a hemorrhagic stroke.

 

Treatment

This is the same as with ischemic stroke, and includes anticoagulants, diet, anaerobic exercises and reduction of stress are extremely important and physical therapy. In recent years, many physicians have been prescribing two aspirins twice a day for prevention.

Pain relievers may be necessary to relieve headache. In some cases surgery may be necessary to evacuate the blood that has leaked into the tissues from the cerebral hemorrhage.

To Learn About Ischemic Strokes.