Hemorrhagic Strokes

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When you think of a stroke, you normally think of a serious problem with the brain. A stroke occurs when a lack of blood supply causes brain damage. Most of the time, a stroke is caused by a blood clot that blocks off one of the arteries that supplies blood to the brain. But sometimes it is actually bleeding in the brain that causes a stroke. This is called a hemorrhagic stroke.

What is a hemorrhage?

A hemorrhage is bleeding.

A hemorrhage can be large or small. There are several causes of brain hemorrhage.

Blood Vessel Leaks- Aneurysm and AVM 

Blood vessels in the brain are like a web of pipes that bring blood to the brain and remove waste material from the brain. When a blood vessel leaks, the blood itself produces brain irritation. But a leak also prevents enough blood from getting to the correct destination. And a gush of blood in the brain produces swelling and compression of important brain structures. So a leaky blood vessel in the brain is harmful in numerous ways.

Brain Aneurysm 

A blood vessel may leak because of a brain aneurysm, which is an out-pouching of one of the arteries that supplies blood to the brain. Blood flows quickly and powerfully through arteries and the out-pouching is usually relatively delicate so it can rip or tear easily, causing a slow, low-volume or high, fast-volume leak.

Arteriovenous Malformation 

Another type of that a blood vessel leak is from an arteriovenous malformation (AVM), which is an abnormal cluster of veins and arteries.

Any of the blood vessels in the cluster can rip or tear, especially when there is very high blood pressure.

A Stroke  

A stroke from a blood clot is called an ischemic stroke. It causes serious damage due to lack of blood supply to the brain. Chemical changes in the brain after an ischemic stroke can make fragile brain tissue and vessels bleed.

Cortical strokes, especially large cortical strokes, are more likely to bleed than strokes in other areas of the brain. This process is called a hemorrhagic transformation of an ischemic stroke and it may lead to serious complications such as compression of the brain from the blood or brain swelling, often called cerebral edema.

Cancer 

When cancer travels from one part of the body to another part, this is called metastasis. When cancer travels to the brain, it can cause bleeding in the brain.

What is the Treatment of a Brain Hemorrhage? 

The first treatment of a brain hemorrhage is management of blood pressure. Very high blood pressure can cause more bleeding. Body fluids have to be managed with great precision, keeping body fluids on the low side to prevent swelling in the brain. If you experience a hemorrhagic stroke, you will likely have to stay in the hospital or even the intensive care unit for a while.

There is no medication available to remove the blood from a hemorrhagic stroke. If the bleeding is severe and takes up space in the brain, it may require surgical removal.

When there is extreme swelling, a surgical procedure to temporarily remove a section of the skull, called a craniotomy, is performed. Recovery from a brain hemorrhage is usually very slow.

Usually after a brain hemorrhage, part of the evaluation includes a search for an AVM or an aneurysm or even cancer.

Complications of Brain Hemorrhage

Sometimes, a hemorrhagic stroke can cause seizures due to brain irritation. Medications called anticonvulsants are used to help control seizures and to prevent them from occurring again.

Most strokes are caused by blood clots. About 15% of strokes are hemorrhagic strokes. Uncertainly and anxiety is normal after a hemorrhagic stroke. Whether you or someone you know has suffered a hemorrhagic stroke, the more you know, the better for you and your loved ones.

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