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.
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:
High blood pressure, which can weaken the walls of the blood vessels and make them prone to rupture.
Aneurysm, which is a bulge or a weak spot in a blood vessel that can burst under pressure.
Arteriovenous malformation, which is a congenital abnormality of the blood vessels that can cause them to tangle and leak.
Brain tumor, which can erode the blood vessels or increase the pressure in the brain.
Head trauma, which can damage the blood vessels or cause bleeding in the brain.
Blood-thinning medication, which can increase the risk of bleeding in the brain.
Recreational drug use, such as cocaine, which can raise the blood pressure and damage the blood vessels.
The symptoms of a hemorrhagic stroke depend on the location and extent of the bleeding in the brain. Some of the common symptoms are:
Sudden and severe headache, often described as the worst headache of one’s life.
Nausea and vomiting.
Loss of consciousness or altered mental state.
Weakness or numbness on one side of the body or face.
Difficulty speaking or understanding speech.
Vision problems, such as blurred vision, double vision, or loss of vision in one or both eyes.
Dizziness, loss of balance, or difficulty walking.
Seizures or convulsions.
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:
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.
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.
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.
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.
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:
Medication, such as blood pressure-lowering drugs, anti-seizure drugs, painkillers, and drugs that reverse the effects of blood-thinning medication.
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.
Rehabilitation, which involves physical, occupational, and speech therapy to help restore the function and quality of life of the stroke survivor.
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:
Monitoring and treating high blood pressure, high cholesterol, diabetes, and other cardiovascular diseases.
Quitting smoking and avoiding recreational drug use.
Limiting alcohol consumption and maintaining a healthy weight.
Eating a balanced diet and exercising regularly.
Taking blood-thinning medication as prescribed and avoiding over-the-counter drugs that can interfere with it, such as aspirin, ibuprofen, and naproxen.
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.
