Hemorrhagic stroke

Hemorrhagic stroke occurs when a blood vessel in the brain ruptures and bleeds into surrounding tissue. If the rupture occurs between the brain and the skull it is called a subarachnoid hemorrhage; hemorrhages that occur within the brain itself are known as intracerebral hemorrhages. The bleeding compresses nearby blood vessels and deprives surrounding tissue of oxygen, creating increased pressure on the brain. In addition, the blood causes irritation to the brain accompanied by swelling. The bleeding is eventually contained by the formation of a mass called a hematoma, which along with the swelling creates added pressure on brain tissue.

The most common cause of hemorrhagic stroke is hypertension-related atherosclerosis. In this situation, the arterial walls weaken and eventually break, leading to an atherosclerotic aneurysm. In other cases, aneurysms are simply caused by weak spots in the artery walls, which can expand like a balloon and eventually burst. The cause of weak arterial walls is not clear, while the development of aneurysms tend to be hereditary.

Arteriovenous malformations (AVM) are another congenital problem that can lead to hemorrhagic stroke. Brain arteries usually connect to veins through capillaries. In people with AVM, the arteries connect directly to the vein. Since blood pressure in arteries is much greater than in veins, the veins may break and bleed into the brain.

Traumatic brain injuries resulting from accidents can also lead to ruptured blood vessels and a spontaneous hemorrhagic stroke.

Hemorrhagic stroke accounts for approximately 15% of all strokes. They are one of the most serious types of stroke and often require surgical intervention.

Immediate and initial treatment is best accomplished in an intensive care unit where emergency equipment is available. Options range from medication to surgery and will depend upon the cause of the stroke and the amount of damage done. If you are experiencing symptoms of a stroke, seek emergency medical care immediately.

Surgery or other intervention is often necessary to save the patient’s life and to promote meaningful recovery. The type of surgery depends upon the cause of the bleeding. If the cause was an aneurysm, the leaking blood vessel often has a clip placed on it to prevent future leaks.

In other cases, a catheter is inserted into the blood vessel and platinum coils released to fill the space created by the aneurysm. Blood clots (hematoma) are removed surgically or by stereotactic aspiration, a less invasive process that uses 3 dimensional X rays to help with the insertion of a needle to suck out the clot.

Radiation methods may also be utilized, especially in cases of AVM. When the AVM is accessible, it is sometimes removed surgically using 3-dimensional X-rays to aid with the surgery.

Rehabilitation is essential to stroke recovery and we have one of the most comprehensive rehabilitation and stroke management centers in the country. Rehabilitation can include various methods - physical therapy, speech therapy, and occupational therapy.

Physical therapy involves using exercise and other physical means, like massage or heat, to help patients regain the use of their arms and legs and to prevent muscle stiffness in patients with permanent paralysis. Speech therapy helps patients regain their ability to speak. Occupational therapy helps patients regain independent function and relearn basic skills like buttoning a shirt, preparing a meal, or bathing.

Risk factors for a hemorrhagic stroke are similar to those of other strokes and include hypertension, elevated cholesterol levels, coagulation defects, diabetes, smoking and drug abuse

Prognosis for hemorrhagic stroke depends on the degree and duration of obstruction or hemorrhage, and the extent of brain tissue death. The location of a hemorrhagic stroke is an important factor in the outcome. If it occurs between the skull and the brain (subarachnoid hemorrhage), a successful surgical outcome is more likely than if the hemorrhage is within the brain itself. Most stroke patients experience some permanent disability that may interfere with mobility, speech, vision, understanding, reasoning, or memory. While it is a less common occurrence, hemorrhagic strokes are more often fatal than ischemic strokes, and the prognosis for recovery is less optimistic.

For more information, please contactt
Bangkok Neuroscience Center
Tel. (662) 310 3011, (662) 755 1011
Email : info@bangkokhospital.com