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Hemorrhagic strokes are a type of stroke that occurs as a result of a burst blood vessel in or around the brain. Since the brain is extra sensitive to any changes, a ruptured blood vessel can cause damage to the surrounding brain tissue and increase the internal pressure within the brain and cause it to swell. Two types of brain hemorrhages include the subarachnoid hemorrhage (SAH) that is caused by a ruptured blood vessel (aneurysm) on the brain surface and intracerebral hemorrhage (ICH) that is caused by high blood pressure and bleeding in the brain. Other causes of a hemorrhagic stroke include abnormalities in the arteries and veins, certain cancers, cerebral amyloid angiopathy, certain medications and drug abuse.

Depending on the location of the stroke, symptoms may include:

• Vertigo
• Lethargy
• Loss or lack of consciousness
• Difficulty hearing
• Difficulty speaking
• Difficulty swallowing
• Blurred or disturbed vision
• Loss of movement in one side of the body
• Numbness or tingling in one side of the body
• Sleepiness
• Headache that increases when lying down and occurs suddenly
• Lack of balance or coordination
• Seizures
• Nausea and vomiting
• Coma
  

Causes

There are certain risk factors that increase a person’s chance of having a stroke. These include:

• Type 2 diabetes
• High blood pressure
• High cholesterol
• Family history or past history of stroke
• Heart disease such as artrial fibrillation
• Obesity and a sedentary lifestyle
• Old age
• Diet high in sodium and fat
• Blood disorders
  

Treatment

Hemorrhagic stroke treatment usually includes:

• Medications used to treat the cause of the bleeding. For example, drugs to control high blood pressure or anticoagulants to treat blood clots. If the patient has been on blood thinners such as warfarin or aspirin, such medication is stopped immediately as they can increase bleeding. Anti-seizure medications may also be required.
• Pressure within the brain is also monitored closely. To do this, a ventriculostomy tube is placed into the brain that measures any elevations in pressure as well as drains any excess cerebrospinal fluid that builds up. A surgery known as decompressive craniotomy may be required to remove the blood clot and reduce the pressure in the brain.
• Surgery may be necessary to reduce pressure in the brain or to stop the bleeding. Surgical treatment is usually performed within the first 48 to 72 hours after the stroke for the best results. In some cases, surgery may be postponed until the patient’s condition totally stabilizes.
• In cases where an aneurysm has caused the stroke, a clamp may be placed on the base of the aneurysm to stop the bleeding and is removed through brain surgery. A less invasive method of removing an aneurysm is known as coil embolization.
• In order to control respiratory problems, a breathing tube and oxygen may be needed.
• Long-term treatment for a stroke includes occupational, physical and speech therapy.
  

Prognosis

The prognosis for brain stem stroke patients depends on how fast the patient was treated. In most cases, the sooner the stroke was managed with medication and medical treatment, the higher the chance of complete recovery. Other factors that affect the hemorrhagic stroke survival rate include the location of the stroke and the extent of the stroke. If treated immediately, the chances of the patient responding to rehabilitative therapies such as speech therapy or physical therapy are also high. In the long-term, this assures complete recovery and a normal life once again.

There are also a number of health problems and complications that can arise as a result of a stroke. These include conditions such as blood clots, urinary tract infections, internal bleeding in the digestive system, heart attack, injuries due to falls or accidents, malnutrition caused by loss of appetite and difficutly eating, pneumonia, seizures, and bedsores.

References:

1. http://www.nlm.nih.gov/medlineplus/ency/article/000726.htm

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