HEMORRHAGIC STROKE

• Hemorrhagic Stroke is a type of stroke that occurs when a blood vessel in the brain breaks or ruptures
• Approximately 20% of the strokes are hemorrhagic in nature
• The most leading cause is high blood pressure occurring when a blood vessel bursts and blood accumulates

• Subarachnoid hemorrhage and
• Intracerebral hemorrhage

ETIOLOGY:

• Traumatic head injury
• Burst of cerebral aneurysm
• A defect of the circulatory system/a cluster of abnormally formed blood vessels (also called arteriovenous malformation or AVMs, usually inherited at birth)

Subarachnoid Hemorrhage

• Subarachnoid hemorrhage – most severe form of a stroke – permanent disability or death
• It can happen suddenly when a major blood vessel bursts upon the surface of the brain causing spilling blood into the cerebrospinal fluid surrounding the brain
• Due to bleeding, the amount of fluid increases in the affected area – enormous pressure on the whole brain – damage to the brain tissue
• Aneurysm is a ballooning of a weakened area of an artery and when left untreated the aneurysm can continuously become weakened until it ruptures and finally bleeds into the brain
• Burst aneurysm can lead to a sudden and severe headache, usually with a description of “thunderclap”
• CT scan or an MRI – detect the presence of subarachnoid hemorrhage

Intracerebral hemorrhage

• Intracerebral hemorrhage happens when there is a burst of a blood vessel in the brain – leaking of blood into the brain
• It is more common among people aged above 60 and can be most commonly caused by high blood pressure
•  It can also be a result of infections, a burst aneurysm tumors or head injuries

ISCHEMIC STROKE

• Ischemic stroke is a sudden loss of brain function and can be caused by partial or complete obstruction of a blood vessel supplying the brain
• Approximately 80% of strokes are ischemic in nature, and it occurs when there is a blockage inside the carotid arteries or in the vertebral arteries
• A fatty deposit (a plaque) or mass of blood cells (a clot) traveling in the blood can get trapped in a narrowed or small artery – obstructing blood flow – occurrence a stroke

There are three types of Ischemic stroke:

1. Lacunar stroke
2. Thrombotic stroke
3. Embolic stroke

1. Lacunar stroke:

• Lacunar stroke contributes to 25% of ischemic strokes and occurs when there is a blockage in one of the smaller blood vessels found inside the brain
• A “hole” of scar tissue is due to the blockage that starves a small part of the brain
• As only a small portion of the brain is affected, lacunar stroke is usually hard to be diagnosed

2. Thrombotic stroke:

• It happens when the artery is clogged by plaque and hardens, or when a cholesterol-filled plaque of atherosclerosis especially in a brain (cerebral), carotid or vertebral artery breaks open – formation of a blood clot over the plaque obstructing blood flow
• Thrombus (blood clot) is a condition where the blockage seals off the blood vessel

3. Embolic Stroke:

• An embolus refers to a piece that breaks off  and can block a blood vessel supplying the brain causing the occurrence of an embolic stroke which contributes 60% of ischemic strokes
• Unless the source is found and treated immediately, people with embolic strokes are at potential risk of another stroke/s
• Embolic strokes hit fast and suddenly and are normally severe

RISK FACTORS OF STROKE

1. High blood pressure is the number one risk factor for strokes.
2. Atrial fibrillation
3. Diabetes mellitus
4. Family history of stroke
5. High cholesterol
6. Increasing age, especially after age 55
7. Race (black people are more likely to die of a stroke)
8. People who have heart disease or poor blood flow in their legs caused by narrowed arteries
9. Being overweight or obese
10. Drinking heavily
11. Eating too much fat or salt
12. Smoking
13. Taking cocaine and other illegal drugs
14. Birth control pills can increase the chances of having blood clots. The risk is highest in women who smoke and are older than 35

Signs & Symptoms of Stroke

Sudden and severe headache

Trouble seeing in one or both eyes

Sudden dizziness

Trouble walking

Sudden confusion

Trouble speaking

Sudden numbness or weakness of the face, arm, or leg