Hemorrhagic Stroke: Causes, Symptoms, Diagnosis, Treatment, and Prevention
A hemorrhagic stroke is a serious and life-threatening condition that occurs when a blood vessel in the brain ruptures and bleeds, which damages the brain tissue and disrupts the blood flow and oxygen supply to it. About 13% of strokes are hemorrhagic strokes, but they are more likely to be fatal than ischemic strokes, caused by blockages in blood vessels.
Causes
There are two main types of hemorrhagic stroke: intracerebral hemorrhage and subarachnoid hemorrhage. When a blood vessel bursts inside the brain, it causes bleeding into the surrounding brain tissue. It occurs when a blood vessel between the brain and the membranes covering it bursts and bleeds into the cerebrospinal fluid filled space.
Some of the common causes of hemorrhagic stroke are:
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High blood pressure, which can weaken the walls of the blood vessels and make them prone to rupture.
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Aneurysm, which is a bulge or a weak spot in a blood vessel that can burst under pressure.
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Arteriovenous malformation, which is a congenital abnormality of the blood vessels that can cause them to tangle and leak.
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Brain tumor, which can erode the blood vessels or increase the pressure in the brain.
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Head trauma, which can damage the blood vessels or cause bleeding in the brain.
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Blood-thinning medication, which can increase the risk of bleeding in the brain.
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Recreational drug use, such as cocaine, which can raise the blood pressure and damage the blood vessels.
Symptoms
The symptoms of a hemorrhagic stroke depend on the location and extent of the bleeding in the brain. Some of the common symptoms are:
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Sudden and severe headache, often described as the worst headache of one’s life.
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Nausea and vomiting.
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Loss of consciousness or altered mental state.
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Weakness or numbness on one side of the body or face.
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Difficulty speaking or understanding speech.
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Vision problems, such as blurred vision, double vision, or loss of vision in one or both eyes.
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Dizziness, loss of balance, or difficulty walking.
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Seizures or convulsions.
Diagnosis
A hemorrhagic stroke is a medical emergency that requires immediate attention. The diagnosis is based on the medical history, physical examination, and imaging tests. Some of the tests that can help diagnose a hemorrhagic stroke are:
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Computed tomography (CT) scan, which uses X-rays to create a detailed image of the brain and can show the location and size of the bleeding.
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Magnetic resonance imaging (MRI) scan, which uses a strong magnetic field and radio waves to create a detailed image of the brain and can show the damage to the brain tissue and blood vessels.
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Cerebral angiography, which uses a dye injected into the blood vessels and X-rays to create a detailed image of the blood vessels and can show the cause of the bleeding, such as an aneurysm or an arteriovenous malformation.
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Lumbar puncture, which involves inserting a needle into the lower back and drawing out some cerebrospinal fluid for analysis. This can help detect blood in the fluid, which can indicate a subarachnoid hemorrhage.
Treatment
The treatment of a hemorrhagic stroke aims to stop the bleeding, reduce the pressure in the brain, and prevent complications. Some of the treatment options are:
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Medication, such as blood pressure-lowering drugs, anti-seizure drugs, painkillers, and drugs that reverse the effects of blood-thinning medication.
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Surgery, such as craniotomy, which involves opening the skull and removing the blood clot or repairing the blood vessel; endovascular coiling, which involves inserting a catheter into the blood vessel and placing a coil to seal off the aneurysm; or stereotactic radiosurgery, which involves using focused radiation to shrink the arteriovenous malformation.
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Rehabilitation, which involves physical, occupational, and speech therapy to help restore the function and quality of life of the stroke survivor.
Prevention
The prevention of a hemorrhagic stroke involves controlling the risk factors and managing the underlying conditions that can cause bleeding in the brain. Some of the preventive measures are:
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Monitoring and treating high blood pressure, high cholesterol, diabetes, and other cardiovascular diseases.
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Quitting smoking and avoiding recreational drug use.
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Limiting alcohol consumption and maintaining a healthy weight.
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Eating a balanced diet and exercising regularly.
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Taking blood-thinning medication as prescribed and avoiding over-the-counter drugs that can interfere with it, such as aspirin, ibuprofen, and naproxen.
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Seeking medical attention for any signs of a stroke or a transient ischemic attack, which is a mini-stroke that can be a warning sign of a future stroke.
