Is one of the two main main categories of a stroke.
The other category is ischemic stroke.
Is the pooling of blood anywhere within the skull.
The brain is very sensitive to increasing damage, blood, fluids and pressure inside its tissues
Swelling can often result increasing damage on area affected as well as the entire brain.
20% of all strokes are hemorrhagic in origin. The other 80% are ischemic strokes which are a lack of oxygen.
Medications used to help treat ischemic strokes can be deadly in hemorrhagic strokes.
Symptoms:
- Headache
- Fatigue
- Nausea
- Vomiting
- Weakness
- Paralysis
- Numbness
- Confusion
- Lethargic
- Anger
- Loss or change in sensation
- Other motor or coordination difficulties
- Speech changes or inability
- Loss of consciousness
- Coma
Causes:
- Tearing or rupture of blood vessel
- Brain Trauma [Head injury]
- Brain aneurysm
- Certain medications
Types
1.) Intra-axial hemorrhage [Blood inside the brain]
2.) Extra-axial hemorrhage [Blood inside skull but outside brain]
Intra-Axial Hemorrhage
- bleeding into brain itself
- also called cerebral hemorrhage
- can see bleeding into ventricles
- very dangerous
- very difficult to treat
Extra-Axial Hemorrhage
- bleeding that occurs within the skull but outside the brain
Three subtypes
1.) Epidural hemorrhage
2.) Subdural hemorrhage
3.) Subarachnoid hemorrhage.
Epidural hemorrhage
- Occurs between the skull and the dura mater [outer most meninx]
– Result of trauma
- May result from tear of the “middle meningeal artery”
- Very dangerous
- Very uncommon
Subdural hemorrhage
- Occurs between the dura mater and the inner meningeal layer
- Different than Epidural hemorrhage which is tear in artery
- Typically is a tear in veins in subdural space
- Increase in intracranial pressure is common
- Caused by trauma
- More common than epidural hemorrhage
- Classic finding in shaken baby syndrome
Subarachnoid hemorrhage
- refers to bleeding into the area around the brain.
- this area is between the pia mater and the arachnoid membrane.
- can be result of head trauma or other
Overall exam for hemorrhagic stroke are essential
Exam by a provider is essential if any concern
CT and MRI are useful and quite helpful for evaluation of the brain
Angiography can be used to find aneurysms
Treatment
Evaluation in Emergency room is often necessary and essential
Stay at hospital (ICU department) is often necessary
Ventilation may be required
Medication for Hypertension
Hyper-osmotic agents
. Mannitol
. Glycerol
. Hypertonic saline solutions
Surgery
- Repaire of aneurysm if appropriate
- Improvement of intercranial pressure
- Removal of blood in brain
- Removal of excess fluid