Hemorrhagic stroke, or cerebral hemorrhage is a form of stroke that occurs when a blood vessel in the brain ruptures. Hemorrhagic strokes are deadlier than their more common counterpart, ischemic strokes. Like ischemic strokes, hemorrhagic strokes interrupt the brain's blood supply, but in addition, blood irritates brain tissue, disrupting the delicate chemical balance, and, if the bleeding continues, the increased intracranial pressure can crush delicate brain tissue (NINDS 1999). Jump to: navigation, search The following codes are used with International Statistical Classification of Diseases and Related Health Problems. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... Jump to: navigation, search A stroke or cerebrovascular accident (CVA) occurs when the blood supply to a part of the brain is suddenly interrupted. ... Jump to: navigation, search The arterial system The blood vessels are part of the circulatory system and function to transport blood throughout the body. ... Jump to: navigation, search The human brain is the center of the central nervous system in humans and the primary control center for the peripheral nervous system. ... This article is about stroke as medical term. ... Jump to: navigation, search Red blood cells (erythrocytes) are present in the blood and help carry oxygen to the rest of the cells in the body Blood is a circulating tissue composed of fluid plasma and cells (red blood cells, white blood cells, platelets). ... Intracranial pressure is the pressure of the cerebrospinal fluid within the central nervous system. ...

Hemorragic stroke can be subarachnoid (bleeding into the subarachnoid space, outside the brain) or intracerebral hemorrhage (within the brain itself) (Cicala 1999). A subarachnoid hemorrhage (SAH) is bleeding into the subarachnoid space surrounding the brain, i. ...

Intracerebral hemorrhage

Intracerebral hemorrhage, or ICH, accounts for 10 to 15% of all strokes (Weibers 2001). It most frequently results from high blood pressure as found in people with hypertension, eclampsia, and abuse of some drugs (Liebeskind, 2004). A third of intracerebral bleeds result in intraventricular hemorrhage, or bleeding within the brain's ventricles (Liebeskind, 2004). ICH has a mortality rate of 44% after 30 days, higher than ischemic stroke or even the very deadly subarachnoid hemorrhage (Liebeskind, 2004). For other forms of hypertension see hypertension (disambiguation) Hypertension or high blood pressure is a medical condition where the blood pressure in the arteries is chronically elevated. ... Jump to: navigation, search This article needs to be cleaned up to conform to a higher standard of quality. ... The ventricular system is a fluid conducting system within the brain. ... A subarachnoid hemorrhage (SAH) is bleeding into the subarachnoid space surrounding the brain, i. ...

Subarachnoid hemorrhage

Subarachnoid hemorrhage, which accounts for 5 to 10% of strokes (Weibers 2001) is the deadliest type of stroke. While ischemic stroke has a thirty-day mortality rate of 20%, subarachnoid bleeds kill 40% of their victims in the same time, disabling half the survivors (NINDS 1999; Weibers 2001). When a vessel in the arachnoid layer of the meninges bursts, blood enters the subarachnoid space where cerebrospinal fluid (CSF) bathes the brain, contaminating it. Since the brain is quite sensitive to changes in pH, extensive damage can result when the chemical balance of the CSF is disturbed by the blood (NINDS 1999). A subarachnoid hemorrhage (SAH) is bleeding into the subarachnoid space surrounding the brain, i. ... The Arachnoid mater is one of the three layers of the meninges, interposed between the dura mater and the pia mater and separated from the pia mater by the subarachnoid space. ... The meninges (singular meninx) are the system of membranes that contain the central nervous system. ... The meninges (singular meninx) are the system of membranes that contain the brain. ... Cerebrospinal fluid (CSF) is a clear bodily fluid that occupies the subarachnoid space in the brain (the space between the skull and the cerebral cortex—more specifically, between the arachnoid and pia layers of the meninges). ... The title of this article begins with a capital letter, due to technical limitations of the MediaWiki software. ...

Symptoms of hemorrhagic stroke

A sudden, severe headache is common in hemorrhagic stroke, and is especially indicative of that if accompanied by stiff neck, facial pain, pain between the eyes, vomiting, or altered consciousness (Weibers, 2001). Other signs of hemorrhagic stroke include those that indicate increased intracranial pressure, caused by swelling or collection of blood. These include increased blood pressure, unequal pupils, especially when one pupil is dilated and does not react to light, headache, vomiting, visual disturbances, and decorticate or decerebrate posturing (Yamamoto, 1996). Intracranial pressure is the pressure of the cerebrospinal fluid within the central nervous system. ... Jump to: navigation, search Blood pressure is the pressure exerted by the blood on the walls of the blood vessels. ... A headache (medically known as cephalalgia) is a condition of mild to severe pain in the head; sometimes upper back or neck pain may also be interpreted as a headache. ... Jump to: navigation, search Vomiting (or emesis) is the forceful expulsion of the contents of ones stomach through the mouth. ...

Pathophysiology

Blood carries plasma proteins, leukocytes and other molecules which damage brain cells when they flood the area. Also, a rise in intracranial pressure exacerbates ischemia by compressing blood vessels and requiring higher blood pressures to force blood into tissues. A positive feedback loop is created: hypoxic tissue swells, and swelling tissue becomes hypoxic (Nurse-Anesthesia.com, 2002). The word plasma has a Greek root which means to be formed or molded (the word plastic shares this root). ... Jump to: navigation, search A representation of the 3D structure of myoglobin, showing coloured alpha helices. ... White Blood Cells is also the name of a White Stripes album. ... Intracranial pressure is the pressure of the cerebrospinal fluid within the central nervous system. ... Hypoxia has several meanings: Hypoxia is the lack of oxygen in tissues, see Hypoxia (medical) Hypoxia is the lack of oxygen in a water body leading to the death of organisms, see Hypoxia (water) This is a disambiguation page — a navigational aid which lists other pages that might otherwise share...

Risk factors

Like ischemic stroke, risk factors for hemorrhagic stroke include inflammation of the heart, hypertension, and arteritis (Weibers 2001). Atherosclerosis, the main risk factor for ischemic stroke (Cicala 1999), also causes heart disease and arterial rupture, so the presence of arterial fatty deposits is a major risk factor for hemorrhagic stroke as well. Factors that pose a risk for hemorrhagic stroke and not ischemic stroke include anticoagulant or thrombolytic therapy, bleeding disorders like hemophilia and thrombocytopenic purpura, arterial dissection, and cocaine use (Weibers 2001). In medicine (cardiology), myocarditis is inflammation of the myocardium, the muscular part of the heart. ... For other forms of hypertension see hypertension (disambiguation) Hypertension or high blood pressure is a medical condition where the blood pressure in the arteries is chronically elevated. ... Arteritis is inflammation of the walls of arteries, usually as a result of infection or auto-immune response. ... There are different forms of heart disease: Coronary heart disease Ischaemic heart disease Cardiovascular disease The study of the heart (and diseases of the heart) is Cardiology This is a disambiguation page, a list of pages that otherwise might share the same title. ... An anticoagulant is a substance that prevents coagulation; that is, it stops blood from clotting. ... Thrombolysis is the breakdown (lysis) by pharmacological means, of blood clots. ... Haemophilia or hemophilia is the name of any of several hereditary genetic illnesses that impair the bodys ability to control bleeding. ... Jump to: navigation, search This article is about the drug Cocaine. ...

Intracerebral hemorrhages may be caused by burst aneurysms or arteriovenous malformations, but are most often caused by hypertension, which can cause the delicate blood vessels in the brain to burst (Cicala 1999). Jump to: navigation, search An aneurysm (or aneurism) (from Greek ανευρυσμα, a dilatation) is a localized dilation or ballooning of a blood vessel. ... Jump to: navigation, search Arteriovenous malformation or AVM is a congenital disorder of the veins and arteries that make up the vascular system . ...

Aneurysm, a weakening and ballooning in the wall of one of the brain's arteries, causes 75-90% of subarachnoid bleeds (Weibers, 2001). Aneurysms may put pressure on the brain tissue, but the real trouble occurs when the weakened wall bursts. The area near the Circle of Willis is a common spot for aneurysms: Small branches off the middle cerebral artery are so prone to burst that they are commonly known as "stroke arteries" (Kapit and Elson, 1977). Jump to: navigation, search An aneurysm (or aneurism) (from Greek ανευρυσμα, a dilatation) is a localized dilation or ballooning of a blood vessel. ... Section of an artery An artery or arterial is also a class of highway. ... Circle of Willis in the human brain. ... The middle cerebral artery (MCA) is one of the three major arteries that supplies blood to the brain. ...

Vascular malformations such as arteriovenous malformation (AVM) are another cause of hemorrhagic stroke. AVM is a congenital condition that consists of a tangle of deformed blood vessels and capillaries with thin walls that can rupture (NINDS 1999). These malformations can cause subarachnoid hemorrhage but more commonly responsible for intracerebral bleeding (Weibers 2001). Vascular malformations and aneurysms usually cause no symptoms and can lie undetected until they cause a stroke. On occasion, they can cause "warning leaks" without actually bursting, causing symptoms like seizure, migraine, or one-sided numbness (Weibers 2001). Jump to: navigation, search Arteriovenous malformation or AVM is a congenital disorder of the veins and arteries that make up the vascular system . ... Capillaries are the smallest of a bodys blood vessels, measuring 5-10 μm. ... Seizures (or convulsions) are temporary alterations in brain function expressing themselves into a changed mental state, tonic or clonic movements and various other symptoms. ... Jump to: navigation, search Hemiparesis is the paralysis of one side of the body. ...

In moyamoya disease, small blood vessels in a network replace normal blood vessels around base of brain because of stenosis or blockage of large arteries surrounding the brain (Weibers, 2001). These blood vessels are delicate and more likely than normal blood vessels to break and cause hemorrhagic stroke.

Unfortunately, some treatments for ischemic stroke aimed at dissolving the occluding blood clot can increase the likelihood of hemorrhagic stroke. Hemorrhagic transformation is the phenomenon in which blood vessels weakened by ischemic stroke rupture to cause hemorrhage in addition (Stroke Center, 2005; Jauch, 2003). Hemorrhagic transformation can occur without antithrombotics, but they increase the risk (Jauch, 2003).

For poorly understood reasons, pregnancy increases hemorrhagic stroke risk, and women who have just given birth are more than 28 times more likely to suffer hemorrhagic strokes than the average person (NINDS 1999).

Epidemiology

Though ischemic strokes are more common, the young, though only a small percentage of stroke sufferers, are more likely to have hemorrhagic strokes than ischemic strokes (NINDS 1999).

See also

• Stroke
• Subarachnoid hemorrhage
• Intracerebral hemorrhage

Jump to: navigation, search A stroke or cerebrovascular accident (CVA) occurs when the blood supply to a part of the brain is suddenly interrupted. ... A subarachnoid hemorrhage (SAH) is bleeding into the subarachnoid space surrounding the brain, i. ...

References

1. Cicala, Roger. The Brain Disorders Sourcebook. Los Angeles, CA: Lowell House, 1999. Electronic reproduction. Boulder, Colo.: NetLibrary, 2000.
2. Jauch, Edward C. 2005. “Acute Stroke Management.” eMedicine.com, Inc. Available.
3. Kapitt W and Lawrence M. The Anatomy Coloring Book. New York, NY: Harper & Row, 1977.
4. Liebeskind, 2004. Intracranial Hemorrhage. Emedicine.com. Available.
5. National Institute of Neurological Disorders and Stroke (NINDS). National Institutes of Health., Stroke: Hope Through Research. June 1999. Available.
6. Nurse-Anesthesia.com. 2002.
7. Stroke Center. 1997-2003. Available.
8. Weibers, D. Stroke-Free for Life: The Complete Guide to Stroke Prevention and Treatment. Harper Collins, New York NY, 2001.
9. Yamamoto, LG. 1996. “Intracranial Hypertension and Brain Herniation Syndromes: Radiology Cases in Pediatric Emergency Medicine" Volume 5, Case 6. Kapiolani Medical Center for Women and Children; University of Hawaii; John A. Burns School of Medicine. Available.