Hemorrhagic Stroke Prognosis
Hemorrhagic stroke results when the blood vessel, mainly a small artery in the brain bursts. As a result, bleeding occurs in the brain and the brain cells do not get the required nutrients such as oxygen and glucose. Subsequently the brain cells die. About 20% of strokes are hemorrhagic.
The blood begins to clot and a hematoma is formed in that portion of the brain. This hematoma if big pushes the brain tissue and causes disruption in its function.
Hemorrhagic stroke are less common than ischemic stroke, but the mortality rate in hemorrhagic stroke is high.
Hemorrhagic Stroke Causes
Hemorrhagic stroke causes due to subarchnoid hemorrhage, or due to intra cerebral hemorrhage.
- Subarachnoid hemorrhage is caused by rupture of vascular aneurism or the rupture of atriovenous malformation. The hemorrhage occurs in the space between the skull and the surface of the brain. When an aneurism bleeds in the brain and in the subarachnoid space the outcome is nearly fatal.
- Intra cerebral hemorrhage is bleeding in the brain, and the main reason is long standing hypertension which causes burst in the small artery in the brain.
- Bleeding in brain tumors.
- Ruptured angioma.
Symptoms of Hemorrhagic Stroke
- Loss of sensation in the limb, usually one side.
- Inability to move hand and leg, usually one side.
- Unable to speak and swallow.
- Impaired vision
- Eyes may get paralyzed.
- Loss of consciousness.
Diagnosis, Treatment of Hemorrhagic Stroke
The history and the symptoms in a hypertensive individual suggest the diagnosis of intra-cerebral hemorrhage. CT scan confirms the diagnosis.
Determine the cause of bleeding, such as high blood pressure, blood vessel malformation, anticoagulant therapy. Patient is shifted in ICU unit and vital statistics are measured. Control the blood pressure. Stop anticoagulants if a person is taking. Vitamin K is usually given intravenously.
Surgical treatment for hemorrhagic stroke is recommended to stop the bleeding and if the hematoma is large, this will depend on the health of the patient at that time. Surgery may be done within 48 to 72 hours or later after the patient settles with all vital signs getting normal.
In pontine hemorrhage and large hematomas the survival is less. Survival from small hematomas is frequent but the neurological deficit may remain severe.
Uncontrolled diabetes, severe hypertension, advanced age carry grave prognosis.
The prognosis of subarachnoid hemorrhage is grave. 35% of the patients die because of extensive brain damage. 15% die in few weeks due to second rupture of aneurysm.