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Hemorrhagic stroke

Hemorrhagic stroke (hypertensive intracerebral hemorrhage) is a cerebral infarction in which blood from the cerebral vessels flows to the brain substance. This results in the impairment of blood supply to the brain tissues and cerebral edema.

Causes

The hemorrhagic stroke can be caused by the following:

  • The main cause of hemorrhagic stroke is hypertension and related microangiopathy (thinning of the walls of blood vessels). High blood pressure can result in a tear within the walls of these blood vessels accompanied by the formation of intracerebral hematomas or hemorrhagic impregnation of the blood components of various parts of the brain. Such hemorrhages are called hypertensive (primary).
  • Secondary hemorrhages are less common. They are caused by ruptured vascular malformations. Arteriovenous malformations are congenital cerebrovascular anomalies and represent tangles of different shapes and sizes formed by the disorderly interlaced pathological vessels. Arteriovenous malformations cause hemorrhagic stroke in 1/10 patients. The rupture usually occurs between the ages of 20 and 40 years.
  • The hemorrhages in the brain tumor can develop under the disguise of hemorrhagic stroke.
  • Bleeding disorders and various blood disorders (e.g. leukemia).

For factors, causes, prevention and further details, see the section Information about Stroke

Consequences of hemorrhagic stroke

An intracerebral hemorrhage leads to the development of cerebral edema. The breakdown of blood and the reaction of brain tissue to blood breakdown products result in the inflammation and necrosis of brain tissues. Thus, the affected areas of the brain stop functioning and consequently the parts of the body regulated by this brain area will not work as well.

The effects of hemorrhagic stroke are very similar to those of ischemic stroke, if a person has suffered hemorrhagic stroke, this can result in:

  • Motor disorders, weakness or paralysis, which can cause difficulty in moving, walking and loss of coordination. Hemiparesis or hemiplegia are the terms used to denote movement disorders affecting only one side of the body.
  • Swallowing disorder. If the person develops impaired swallowing, both food and liquid can get into the respiratory tract or lungs but not into the esophagus. The person can therefore develop severe lung inflammation. Swallowing disorders can also cause constipation and dehydration.
  • Speech disorder. Damage to the left hemisphere of the brain results in impaired speech production and understanding, including difficulty reading, writing and counting.
  • Problems of perception. Even with normal vision, the sufferer is unable to understand what he/she sees. Perceptual disorders make it difficult for the person to use everyday objects. For example, the person cannot take a glass and pour water into it and drink it.
  • Cognitive disorders. In these disorders the person’s ability to mental perception and processing of external information becomes impaired. Patient lacks clear and logical thinking, memory gets worse, loses the ability to learn, make decisions and plan ahead.
  • Behavioral disorders. The person can experience aggression, slow response, fearfulness, emotional instability and disorganization.
  • Bowel and bladder problems. Stroke can cause a variety of different problems, resulting in either bowel or bladder dysfunction (fecal or urinary incontinence or retention).
  • Psychological disorders. These include mood swings, depression, irritability, episodes of laughing or crying without an evident reason. Depression is a very common problem for people who have suffered stroke. It is often accompanied by loss of appetite, episodes of causeless laughing or crying, insomnia, low self-esteem and an increased sense of anxiety.
  • Epilepsy. The number of stroke patients who eventually develop epilepsy ranges from 7% to 20%.
  • Pain syndrome. A small number of stroke patients can develop pain episodes manifested in burning, shooting and throbbing pain, which cannot be relieved with painkillers.

Prognosis

In Russia, hemorrhagic stroke results in the highest level of disability among surviving patients, which reaches 75%. Mortality and disability among all subgroups of acute cerebrovascular accidents.

If the doctors have failed to determine the cause of hemorrhagic stroke and select incorrect treatment, the patient is very likely to have a recurrent and sometimes even fatal cerebral hemorrhage.

Treatment and rehabilitation

With a detailed and in-depth diagnosis of causes of hemorrhagic stroke, hemorrhagic stroke and rehabilitation, millions of people who have suffered the condition can return to their normal life.

The main cause of hemorrhagic stroke is hypertension.
With the appropriate treatment of hypertension, normalization of blood pressure, one can prevent recurrent cerebral hemorrhages.

If the cause of hemorrhagic stroke was bleeding from the arteriovenous malformation, and if this disease was not diagnosed, the probability of another and fatal hemorrhage to the brain reaches almost 100%. A timely detection of the arteriovenous malformation and its surgical treatment can return a person to a normal life.

To receive professional consult on the treatment of hemorrhagic stroke in Germany
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