Hemorrhagic stroke: what is it?
Hemorrhagic stroke is bleeding in the brain caused by the rupture of the artery and bleeding into the surrounding tissue. This bleeding kills brain cells. Hemorrhagic stroke also called a brain hemorrhage, intracranial or intracerebral hemorrhage (hematoma). He is 13 – 15% of all strokes, but is responsible for 40% of deaths from these diseases.
What is it – cerebral hemorrhage?
Deep brain structures krovosnabjaemah tiny arteries. High blood pressure can lead to rupture of these small arteries, causing blood to enter brain tissue. The blood is collected and forms a clot, which increases in size and presses on the surrounding tissue.
Increased intracranial pressure disrupts the activity of the brain. Because blood cells in the outbreak of hemorrhagic stroke die, toxins are released that cause further damage to narocito in the hematoma surrounding brain tissue. Intracerebral hemorrhage may develop near the surface or in deep areas of the brain. Sometimes deep bruises may break into the ventricles – fluid filled spaces in the Central part of the brain.
What are the symptoms of intracerebral hematoma?
Signs of intracranial hemorrhage, usually appear suddenly and can vary greatly depending on the localization of hematomas. The most frequent symptoms are:
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- headache, nausea and vomiting;
- drowsiness or impaired consciousness;
- sudden weakness or numbness of face, arm or leg, growing usually on one side;
- temporary loss of vision;
What are the causes of intracranial hemorrhage?
The most common causes of hemorrhagic stroke:
- Hypertension – high blood pressure can lead to rupture of the small arteries inside the brain.
- Treatment krivorozchskiy drugs – these funds (Coumadin, Heparin, Warfarin, Xarelto) are used to treat heart disease and strokes.
- Arteriovenous malformation – a tangle of abnormal arteries and veins are connected directly rather than through capillaries.
- Aneurysm – a bulge or weakening of an arterial wall.
- Disorders of blood clotting – haemophilia, sickle cell anemia, DIC, thrombocytopenia.
- Tumor much krovosnabjaemye tumors (angiomas and metastatic tumors) can bleed inside the brain tissue.
- Amyloid angiopathy a degenerative disease of the arteries.
- The drug cocaine and other drugs can cause intracerebral hemorrhage.
As a diagnosis?
In addition to inspection and examination by a neurologist to establish the diagnosis and determine the source and location of hemorrhage can help:
- CT is a noninvasive radiographic technique to visualize the anatomical structures and the detection of hematomas inside the brain. To study the arteries of the brain using computer tomography with intravenous contrast.
- Angiography is an invasive procedure in which an artery catheter and carried through the blood vessels in the brain. Then injected the contrast and fluoroscopy is carried out.
- Magnetic resonance imaging is a noninvasive examination that uses magnetic field and radio waves to construct detailed images of the soft tissues of the brain.
What is the treatment?
After identifying the cause and localization of hemorrhagic stroke is conservative or surgical treatment to stop the bleeding, remove the clot and reduce pressure on the brain. As a rule, patients with small hematomas in the brain and minimal symptoms are treated conservatively. When large hemorrhages or their specific locations (for example, in the cerebellum) is often carried out surgical treatment.
The most important factor of good prognosis for hemorrhagic stroke is to control intracranial pressure. Assigned the following drugs: pain relievers, corticosteroids, diuretics and anticonvulsants.
The goal of surgical treatment is excision of the clot and stop the bleeding. There are two operation methods, which are used depending on the localization of the hematoma:
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- Craniotomy, the neurosurgeon makes a hole in the skull, and then removes the blood clot. This technique is used in cases when the hematoma is close to the surface of the brain or when associated with arteriovenous malformation or tumor that also need to be removed.
- Stereotactic aspiration is a less invasive technique used for large hematomas located deep in the brain.
Can people after hemorrhagic stroke fully recover?
The prognosis for hemorrhagic stroke depends on the size and location of hemorrhage, degree of cerebral edema. Some patients can recover completely, others to stay and live with defined disorders of the brain, others to die.